{"reporting_entity_name":"Healthfirst Insurance Company","reporting_entity_type":"Health Insurance Issuer","last_updated_on":"2026-06-24","version":"2.0.0","provider_references":[{"provider_group_id":1,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1000000000],"tin":{"type":"npi","value":"1000000000"}}]},{"provider_group_id":2,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003861725],"tin":{"type":"npi","value":"1003861725"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003378845],"tin":{"type":"npi","value":"1003378845"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003575085],"tin":{"type":"npi","value":"1003575085"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184935264],"tin":{"type":"npi","value":"1184935264"}}]},{"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":[1487790259],"tin":{"type":"npi","value":"1487790259"}}]}],"in_network":[{"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0144T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35693","name":"Art trnsposj subclavian","description":"Transposition and/or reimplantation; vertebral to subclavian artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50395","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86023","name":"Immunoglobulin assay","description":"Antibody identification; platelet associated immunoglobulin assay","date_of_service":"2026-06-05","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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-06-05","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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-06-05","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":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"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":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10509","10512","10516","10524","10537","10541","10542","10579","10910","10912","10914","10915","10916","10917","10918","10919","10921","10922","10924","10925","10926","10928","10930","10932","10933","10940","10941","10943","10949","10950","10953","10958","10959","10963","10969","10973","10975","10979","10981","10985","10987","10988","10990","10992","10996","10997","10998","12015","12017","12029","12037","12042","12050","12051","12058","12060","12075","12083","12087","12106","12115","12124","12125","12130","12132","12136","12165","12167","12172","12173","12174","12176","12184","12192","12195","12401","12402","12404","12405","12406","12407","12409","12410","12411","12412","12413","12414","12416","12417","12418","12419","12420","12421","12422","12423","12424","12427","12428","12429","12430","12431","12432","12433","12434","12435","12436","12438","12439","12440","12441","12442","12443","12444","12446","12448","12449","12450","12451","12452","12453","12454","12455","12456","12457","12458","12459","12460","12461","12463","12464","12465","12466","12468","12470","12471","12472","12473","12474","12475","12477","12480","12481","12482","12483","12484","12485","12486","12487","12489","12490","12491","12492","12493","12494","12495","12496","12498","12501","12502","12503","12504","12506","12507","12508","12510","12511","12512","12513","12514","12515","12516","12517","12518","12520","12521","12522","12523","12524","12525","12526","12527","12528","12529","12530","12531","12533","12534","12537","12538","12540","12541","12542","12543","12544","12545","12546","12547","12548","12549","12550","12551","12552","12553","12555","12561","12563","12564","12565","12566","12567","12568","12569","12570","12571","12572","12574","12575","12577","12578","12580","12581","12582","12583","12584","12585","12586","12588","12589","12590","12592","12593","12594","12601","12602","12603","12604","12701","12719","12720","12721","12722","12723","12724","12725","12726","12727","12729","12732","12733","12734","12736","12737","12738","12740","12741","12742","12743","12745","12746","12747","12748","12749","12750","12751","12752","12754","12758","12759","12760","12762","12763","12764","12765","12766","12767","12768","12769","12770","12771","12775","12776","12777","12778","12779","12780","12781","12782","12783","12784","12785","12786","12787","12788","12789","12790","12791","12792","13731","13739","13740","13750","13751","13752","13753","13755","13756","13757","13774","13775","13782","13783","13786","13788","13804","13806","13837","13838","13839","13842","13846","13847","13856","13860"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"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":"46211","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-06-05","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":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-06-05","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":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35501","name":"Art byp grft ipsilat carotid","description":"Bypass graft, with vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"52647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-05","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":"83026","name":"Hemoglobin copper sulfate","description":"Hemoglobin; by copper sulfate method, non-automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82960","name":"Test for g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); screen","date_of_service":"2026-06-05","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":["AV","AU","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":"2026-06-05","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":"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":"2026-06-05","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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43760","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15335","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","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":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"M0243","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92341","name":"Fit spectacles bifocal","description":"Fitting of spectacles, except for aphakia; bifocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90865","name":"Narcosynthesis","description":"Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (amytal) interview)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64412","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-06-05","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":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-06-05","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":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"89140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65785","name":"Impltj ntrstrml crnl rng seg","description":"Implantation of intrastromal corneal ring segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35539","name":"Art byp grft aortofemoral","description":"Bypass graft, with vein; aortofemoral","date_of_service":"2026-06-05","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":"15775","name":"Hair trnspl 1-15 punch grfts","description":"Punch graft for hair transplant; 1 to 15 punch grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15922","name":"Exc coccygl pr ulc flap clsr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure","date_of_service":"2026-06-05","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":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51525","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93529","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"90808","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43261","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with biopsy, single or multiple","date_of_service":"2026-06-05","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":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44602","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60502","name":"Re-explore parathyroids","description":"Parathyroidectomy or exploration of parathyroid(s); re-exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50220","name":"Remove kidney open","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection;","date_of_service":"2026-06-05","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":"37618","name":"Ligation major artery xtr","description":"Ligation, major artery (eg, post-traumatic, rupture); extremity","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"87512","name":"Gardner vag dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, quantification","date_of_service":"2026-06-05","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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-06-05","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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"55870","name":"Electroejaculation","description":"Electroejaculation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49081","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"19302","name":"P-mastectomy w/ln removal","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43268","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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 observ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75960","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-05","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":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-05","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"11772","name":"Exc pilonidal cyst comp","description":"Excision of pilonidal cyst or sinus; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-06-05","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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-06-05","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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83008","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94240","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"66160","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54105","name":"Biopsy of penis","description":"Biopsy of penis; deep structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-05","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-05","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":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93526","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3265","name":"Plastazote sandal each","description":"Plastazote sandal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92070","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27193","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28737","name":"Revision of foot bones","description":"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99337","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-06-05","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"62120","name":"Repair skull cavity lesion","description":"Repair of encephalocele, skull vault, including cranioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-06-05","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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-05","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":"64420","name":"Njx aa&/strd ntrcost nrv 1","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29899","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","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":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-06-05","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":"93501","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86406","name":"Particle agglut antbdy titr","description":"Particle agglutination; titer, each antibody","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-05","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":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53410","name":"Reconstruction of urethra","description":"Urethroplasty, 1-stage reconstruction of male anterior urethra","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-06-05","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":"17340","name":"Cryotherapy for acne","description":"Cryotherapy (co2 slush, liquid n2) for acne","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36002","name":"Pseudoaneurysm injection trt","description":"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67805","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, different lids","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-05","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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-06-05","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":"99149","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57170","name":"Fitting of diaphragm/cap","description":"Diaphragm or cervical cap fitting with instructions","date_of_service":"2026-06-05","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":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"C1758","name":"Catheter, ureteral","description":"Catheter, ureteral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"38531","name":"Open bx/exc inguinofem nodes","description":"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86729","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92571","name":"Filtered speech test","description":"Filtered speech test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64823","name":"Sympathectomy supfc palmar","description":"Sympathectomy; superficial palmar arch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3673","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"41512","name":"Tongue suspension","description":"Tongue base suspension, permanent suture technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86922","name":"Compatibility test antiglob","description":"Compatibility test each unit; antiglobulin technique","date_of_service":"2026-06-05","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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-05","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-05","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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-06-05","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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-06-05","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":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36512","name":"Apheresis rbc","description":"Therapeutic apheresis; for red blood cells","date_of_service":"2026-06-05","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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33310","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0191T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"H0016","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86744","name":"Nocardia antibody","description":"Antibody; nocardia","date_of_service":"2026-06-05","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":"L3253","name":"Shoe molded plastazote cust","description":"Foot, molded shoe plastazote (or similar) custom fitted, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26860","name":"Fusion of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation;","date_of_service":"2026-06-05","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":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-05","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":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-06-05","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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91301","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"61334","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","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":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36515","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27647","name":"Resect talus/calcaneus tum","description":"Radical resection of tumor; talus or calcaneus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"96154","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-05","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":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-06-05","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"34421","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision","date_of_service":"2026-06-05","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-06-05","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":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40845","name":"Reconstruction of mouth","description":"Vestibuloplasty; complex (including ridge extension, muscle repositioning)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6215","name":"Foam dressing wound filler","description":"Foam dressing, wound filler, sterile, per gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"19260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67343","name":"Release eye tissue","description":"Release of extensive scar tissue without detaching extraocular muscle (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43252","name":"Egd optical endomicroscopy","description":"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-06-05","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":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-06-05","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":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-06-05","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":"87252","name":"Virus inoculation tissue","description":"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84206","name":"Assay of proinsulin","description":"Proinsulin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"46916","name":"Cryosurgery anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-05","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":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-06-05","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":"62142","name":"Rmvl b1 flp/prostc plate skl","description":"Removal of bone flap or prosthetic plate of skull","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"38555","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection","date_of_service":"2026-06-05","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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26445","name":"Release hand/finger tendon","description":"Tenolysis, extensor tendon, hand or finger, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-06-05","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":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-06-05","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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-06-05","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":"62000","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; simple, extradural","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-06-05","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":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0309","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-06-05","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":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"49420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85540","name":"Wbc alkaline phosphatase","description":"Leukocyte alkaline phosphatase with count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42300","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82172","name":"Assay of apolipoprotein","description":"Apolipoprotein, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-06-05","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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43520","name":"Incision of pyloric muscle","description":"Pyloromyotomy, cutting of pyloric muscle (fredet-ramstedt type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-06-05","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":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-06-05","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":"27818","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"21705","name":"Revision of neck muscle/rib","description":"Division of scalenus anticus; with resection of cervical rib","date_of_service":"2026-06-05","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":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-05","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-05","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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64623","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"78267","name":"Urea breath tst c-14 acquisj","description":"Urea breath test, c-14 (isotopic); acquisition for analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5999","name":"Lowr extremity prosthes nos","description":"Lower extremity prosthesis, not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-06-05","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":"29868","name":"Meniscal trnspl knee w/scpe","description":"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67921","name":"Repair eyelid defect","description":"Repair of entropion; suture","date_of_service":"2026-06-05","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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-06-05","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":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":["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":"2026-06-05","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":"A6201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82575","name":"Creatinine clearance test","description":"Creatinine; clearance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"T4541","name":"Large disposable underpad","description":"Incontinence product, disposable underpad, large, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-06-05","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":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22902","name":"Exc abd les sc < 3 cm","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0431","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46030","name":"Removal anal seton oth mrk","description":"Removal of anal seton, other marker","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82331","name":"Calcium infusion test","description":"Calcium; after calcium infusion test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82803","name":"Blood gases any combination","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86708","name":"Hepatitis a antibody","description":"Hepatitis a antibody (haab)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50820","name":"Construct bowel bladder","description":"Ureteroileal conduit (ileal bladder), including intestine anastomosis (bricker operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50548","name":"Laparo remove w/ureter","description":"Laparoscopy, surgical; nephrectomy with total ureterectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90812","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83497","name":"Assay of 5-hiaa","description":"Hydroxyindolacetic acid, 5-(hiaa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59100","name":"Remove uterus lesion","description":"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-06-05","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":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31239","name":"Nsl/sinus endoscopy surg dcr","description":"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41820","name":"Excision gum each quadrant","description":"Gingivectomy, excision gingiva, each quadrant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-06-05","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":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66850","name":"Removal of lens material","description":"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration","date_of_service":"2026-06-05","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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-06-05","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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35632","name":"Bpg ilio-celiac","description":"Bypass graft, with other than vein; ilio-celiac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82042","name":"Other source albumin quan ea","description":"Albumin; other source, quantitative, each specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"0497T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64910","name":"Nerve repair w/allograft","description":"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"T4522","name":"Adult size brief/diaper med","description":"Adult sized disposable incontinence product, brief/diaper, medium, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33233","name":"Removal of pm generator","description":"Removal of permanent pacemaker pulse generator only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82742","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24560","name":"Cltx hum epcndylr fx wo mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-05","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":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-06-05","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":"87152","name":"Culture type pulse field gel","description":"Culture, typing; identification by pulse field gel typing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83912","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65772","name":"Correction of astigmatism","description":"Corneal relaxing incision for correction of surgically induced astigmatism","date_of_service":"2026-06-05","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":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45387","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49203","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68335","name":"Revise/graft eyelid lining","description":"Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24305","name":"Tendon lngth upr a/e ea tdn","description":"Tendon lengthening, upper arm or elbow, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"B4082","name":"Enteral ng tubing w/o stylet","description":"Nasogastric tubing without stylet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24940","name":"Revision of upper arm","description":"Cineplasty, upper extremity, complete procedure","date_of_service":"2026-06-05","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":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-05","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":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-06-05","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-05","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":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-05","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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65920","name":"Remove implant of eye","description":"Removal of implanted material, anterior segment of eye","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82106","name":"Alpha-fetoprotein amniotic","description":"Alpha-fetoprotein (afp); amniotic fluid","date_of_service":"2026-06-05","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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82387","name":"Assay of cathepsin-d","description":"Cathepsin-d","date_of_service":"2026-06-05","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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46938","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82610","name":"Cystatin c","description":"Cystatin c","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2770","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-05","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":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","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":"54650","name":"Orchiopexy (fowler-stephens)","description":"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler-stephens)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86901","name":"Blood typing serologic rh(d)","description":"Blood typing, serologic; rh (d)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68320","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-05","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":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4657","name":"Syringe w/wo needle","description":"Syringe, with or without needle, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26650","name":"Treat thumb fracture","description":"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-05","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":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-06-05","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":"45160","name":"Excision of rectal lesion","description":"Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21600","name":"Partial removal of rib","description":"Excision of rib, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64905","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"56440","name":"Mrsplzatn brthlns glnd cst","description":"Marsupialization of bartholins gland cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"35207","name":"Rpr bld vsl dir hand finger","description":"Repair blood vessel, direct; hand, finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4269","name":"Spermicide","description":"Contraceptive supply, spermicide (e.g., foam, gel), each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54450","name":"Preputial stretching","description":"Foreskin manipulation including lysis of preputial adhesions and stretching","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23800","name":"Arthrodesis glenohumeral jt","description":"Arthrodesis, glenohumeral joint;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33335","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33361","name":"Replace aortic valve perq","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; percutaneous femoral artery approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-06-05","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":"37203","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-05","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":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-06-05","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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-05","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":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G2062","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67912","name":"Correction eyelid w/implant","description":"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4081","name":"Enteral ng tubing w/ stylet","description":"Nasogastric tubing with stylet","date_of_service":"2026-06-05","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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"25259","name":"Manipulate wrist w/anesthes","description":"Manipulation, wrist, under anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84134","name":"Assay of prealbumin","description":"Prealbumin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"38700","name":"Removal of lymph nodes neck","description":"Suprahyoid lymphadenectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-06-05","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":"33702","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0019T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","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":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-06-05","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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27120","name":"Reconstruction of hip socket","description":"Acetabuloplasty; (eg, whitman, colonna, haygroves, or cup type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-06-05","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":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":["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":"2026-06-05","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":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90997","name":"Hemoperfusion","description":"Hemoperfusion (eg, with activated charcoal or resin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-06-05","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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"93014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0485T","name":"Oct mid ear i&r unilateral","description":"Optical coherence tomography (oct) of middle ear, with interpretation and report; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4580","name":"Cast supplies (plaster)","description":"Cast supplies (e.g., plaster)","date_of_service":"2026-06-05","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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"80185","name":"Assay of phenytoin total","description":"Phenytoin; total","date_of_service":"2026-06-05","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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0394","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","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":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-06-05","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":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86386","name":"Nuclear matrix protein 22","description":"Nuclear matrix protein 22 (nmp22), qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46744","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-05","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":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4671","name":"Disposable cycler set","description":"Disposable cycler set used with cycler dialysis machine, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"60252","name":"Removal of thyroid","description":"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-06-05","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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4533","name":"Youth size brief/diaper","description":"Youth sized disposable incontinence product, brief/diaper, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A6250","name":"Skin seal protect moisturizr","description":"Skin sealants, protectants, moisturizers, ointments, any type, any size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-06-05","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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-05","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":"23222","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-06-05","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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20670","name":"Removal implant superficial","description":"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87497","name":"Cytomeg dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26852","name":"Fusion of knuckle with graft","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"0478T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"61571","name":"Incise skull for brain wound","description":"Craniectomy or craniotomy; with treatment of penetrating wound of brain","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-05","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":"G0104","name":"Ca screen;flexi sigmoidscope","description":"Colorectal cancer screening; flexible sigmoidoscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27006","name":"Tenotomy abductor&/xtnsr hip","description":"Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24153","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46707","name":"Repair anorectal fist w/plug","description":"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [sis])","date_of_service":"2026-06-05","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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-06-05","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-06-05","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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-05","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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15740","name":"Island pedicle flap graft","description":"Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65270","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84377","name":"Sugars multiple qual","description":"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78593","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"66720","name":"Destruction ciliary body","description":"Ciliary body destruction; cryotherapy","date_of_service":"2026-06-05","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":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-06-05","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":"85612","name":"Viper venom prothrombin time","description":"Russell viper venom time (includes venom); undiluted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-06-05","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":"0356T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-05","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","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":"11760","name":"Repair of nail bed","description":"Repair of nail bed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-05","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":"65135","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21255","name":"Reconstruct lower jaw bone","description":"Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31582","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A9512","name":"Tc99m pertechnetate","description":"Technetium tc-99m pertechnetate, diagnostic, per millicurie","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9686","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83634","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64714","name":"Revise low back nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-05","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":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0502","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-05","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":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32422","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82690","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27695","name":"Repair of ankle ligament","description":"Repair, primary, disrupted ligament, ankle; collateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0166","name":"Extrnl counterpulse, per tx","description":"External counterpulsation, per treatment session","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86309","name":"Heterophile antibody titer","description":"Heterophile antibodies; titer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"68750","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent","date_of_service":"2026-06-05","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":"61332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19340","name":"Insj breast implt sm d mast","description":"Insertion of breast implant on same day of mastectomy (ie, immediate)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"63195","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-05","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":"0540T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0031A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"35537","name":"Art byp grft aortoiliac","description":"Bypass graft, with vein; aortoiliac","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67036","name":"Removal of inner eye fluid","description":"Vitrectomy, mechanical, pars plana approach;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68328","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78591","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27508","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44160","name":"Removal of colon","description":"Colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"L3255","name":"Orth foot non-standard size/","description":"Non-standard size or length","date_of_service":"2026-06-05","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":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","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":"86807","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); standard method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82108","name":"Assay of aluminum","description":"Aluminum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62267","name":"Interdiscal perq aspir dx","description":"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-06-05","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":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-06-05","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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-05","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":"33321","name":"Repair major vessel","description":"Suture repair of aorta or great vessels; with shunt bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21360","name":"Opn tx dprsd malar fracture","description":"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"19102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-06-05","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":"27326","name":"Neurectomy popliteal","description":"Neurectomy, popliteal (gastrocnemius)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86593","name":"Syphilis test non-trep quant","description":"Syphilis test, non-treponemal antibody; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4220","name":"Infusion pump refill kit","description":"Refill kit for implantable infusion pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57112","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7499","name":"Upper extremity prosthes nos","description":"Upper extremity prosthesis, not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99224","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-06-05","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":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"96360","name":"Hydration iv infusion init","description":"Intravenous infusion, hydration; initial, 31 minutes to 1 hour","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-06-05","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":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85097","name":"Bone marrow interpretation","description":"Bone marrow, smear interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-05","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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21230","name":"Rib cartilage graft","description":"Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L0210","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0512","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64553","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; cranial nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"33870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"65286","name":"Repair of eye wound","description":"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86022","name":"Platelet antibodies","description":"Antibody identification; platelet antibodies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"19291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43842","name":"Gstr rstcv px v-banded gstp","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48552","name":"Prep donor pancreas/venous","description":"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-05","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":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90862","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80152","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"97762","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22865","name":"Rmvl tot arthrp 1ntrspc lmbr","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-05","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"29358","name":"Appl long leg cast brace","description":"Application of long leg cast brace","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0246","name":"Transfer tub rail attachment","description":"Transfer tub rail attachment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-05","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":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54512","name":"Excise lesion testis","description":"Excision of extraparenchymal lesion of testis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G6014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"63615","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"01935","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-05","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":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","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":"21360","name":"Opn tx dprsd malar fracture","description":"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49083","name":"Abd paracentesis w/imaging","description":"Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27475","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"21261","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"35571","name":"Art byp pop-tibl-prl-other","description":"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"58823","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-05","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":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-06-05","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":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-06-05","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":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"15366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24500","name":"Cltx humrl shft fx w/o mnpj","description":"Closed treatment of humeral shaft fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"60000","name":"I&d thyroglssl dux cst infct","description":"Incision and drainage of thyroglossal duct cyst, infected","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0236T","name":"Trluml perip athrc abd aorta","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; abdominal aorta","date_of_service":"2026-06-05","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":"53040","name":"Drainage of urethra abscess","description":"Drainage of deep periurethral abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"77409","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-05","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":"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 indiv","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-05","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":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47100","name":"Wedge biopsy of liver","description":"Biopsy of liver, wedge","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31552","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-06-05","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":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86336","name":"Inhibin a","description":"Inhibin a","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3673","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63196","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24105","name":"Excision olecranon bursa","description":"Excision, olecranon bursa","date_of_service":"2026-06-05","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":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25110","name":"Remove wrist tendon lesion","description":"Excision, lesion of tendon sheath, forearm and/or wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84578","name":"Test urine urobilinogen","description":"Urobilinogen, urine; qualitative","date_of_service":"2026-06-05","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":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-06-05","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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-05","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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86906","name":"Bld typing serologic rh phnt","description":"Blood typing, serologic; rh phenotyping, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","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":"86001","name":"Allergen specific igg","description":"Allergen specific igg quantitative or semiquantitative, each allergen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-05","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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33016","name":"Pericardiocentesis w/imaging","description":"Pericardiocentesis, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35522","name":"Art byp grft axill-brachial","description":"Bypass graft, with vein; axillary-brachial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45172","name":"Exc rect tum transanal full","description":"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)","date_of_service":"2026-06-05","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":"26990","name":"Drainage of pelvis lesion","description":"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27350","name":"Removal of kneecap","description":"Patellectomy or hemipatellectomy","date_of_service":"2026-06-05","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":"33230","name":"Insrt pulse gen w/dual leads","description":"Insertion of implantable defibrillator pulse generator only; with existing dual leads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP21","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64565","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15430","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27252","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; requiring anesthesia","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0245T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-06-05","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":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29105","name":"Application long arm splint","description":"Application of long arm splint (shoulder to hand)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82777","name":"Galectin-3","description":"Galectin-3","date_of_service":"2026-06-05","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":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29887","name":"Arthrs knee srg drlg od fixj","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","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":["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":"2026-06-05","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":"21339","name":"Open nasoethmoid fx w/ fixj","description":"Open treatment of nasoethmoid fracture; with external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"58957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90816","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-05","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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0274","name":"Over-bed table","description":"Over-bed table","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42842","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27267","name":"Cltx thigh fx","description":"Closed treatment of femoral fracture, proximal end, head; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"35647","name":"Bpg aortofemoral","description":"Bypass graft, with other than vein; aortofemoral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-05","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":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2065","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-06-05","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-05","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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32670","name":"Thoracoscopy bilobectomy","description":"Thoracoscopy, surgical; with removal of two lobes (bilobectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92226","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76880","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82488","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24365","name":"Reconstruct head of radius","description":"Arthroplasty, radial head;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-06-05","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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-05","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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-06-05","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":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-06-05","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":"68840","name":"Explore/irrigate tear ducts","description":"Probing of lacrimal canaliculi, with or without irrigation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0296T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-06-05","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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29720","name":"Repair spica body cst/jacket","description":"Repair of spica, body cast or jacket","date_of_service":"2026-06-05","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":"24300","name":"Mnpj elbow under anes","description":"Manipulation, elbow, under anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23472","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"S0191","name":"Misoprostol, oral, 200 mcg","description":"Misoprostol, oral, 200 mcg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"57156","name":"Ins vag brachytx device","description":"Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy","date_of_service":"2026-06-05","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":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25909","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; re-amputation","date_of_service":"2026-06-05","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":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-05","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":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-05","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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35474","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"24140","name":"Partial exc bone humerus","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35372","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92582","name":"Conditioning play audiometry","description":"Conditioning play audiometry","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-05","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":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29907","name":"Subtalar arthro w/fusion","description":"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24300","name":"Mnpj elbow under anes","description":"Manipulation, elbow, under anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11771","name":"Exc pilonidal cyst xtnsv","description":"Excision of pilonidal cyst or sinus; extensive","date_of_service":"2026-06-05","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":"37500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43198","name":"Esophagosc flex trnsn biopsy","description":"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58275","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80166","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-06-05","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":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"35526","name":"Art byp grft aor/carot/innom","description":"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-05","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":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1901","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-06-05","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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25505","name":"Cltx rdl shft fx w/mnpj","description":"Closed treatment of radial shaft fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G6008","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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 underst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61546","name":"Removal of pituitary gland","description":"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-05","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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29125","name":"Appl short arm splint static","description":"Application of short arm splint (forearm to hand); static","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66761","name":"Revision of iris","description":"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-05","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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-06-05","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":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44901","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-06-05","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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-05","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":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65420","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; without graft","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21451","name":"Cltx mndblr fx w/mnpj","description":"Closed treatment of mandibular fracture; with manipulation","date_of_service":"2026-06-05","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"68761","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by plug, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-06-05","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":"92993","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85420","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay","date_of_service":"2026-06-05","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":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15952","name":"Exc trchntr pr ulc flp clsr","description":"Excision, trochanteric pressure ulcer, with skin flap closure;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29700","name":"Rmvl/bivlv gauntlet boot/cst","description":"Removal or bivalving; gauntlet, boot or body cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"44137","name":"Remove intestinal allograft","description":"Removal of transplanted intestinal allograft, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G2064","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26479","name":"Shortening of hand tendon","description":"Shortening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55520","name":"Removal of sperm cord lesion","description":"Excision of lesion of spermatic cord (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38305","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42830","name":"Removal of adenoids","description":"Adenoidectomy, primary; younger than age 12","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-06-05","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":"36833","name":"Av fistula revision","description":"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-06-05","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":"50650","name":"Removal of ureter","description":"Ureterectomy, with bladder cuff (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28312","name":"Revision of toe","description":"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-05","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":"91055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84270","name":"Assay of sex hormone globul","description":"Sex hormone binding globulin (shbg)","date_of_service":"2026-06-05","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":"82488","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85240","name":"Clot factor viii ahg 1 stage","description":"Clotting; factor viii (ahg), 1-stage","date_of_service":"2026-06-05","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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63272","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"55600","name":"Vesiculotomy","description":"Vesiculotomy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32098","name":"Open biopsy of lung pleura","description":"Thoracotomy, with biopsy(ies) of pleura","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83866","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77404","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"89136","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92992","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68500","name":"Removal of tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37231","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4550","name":"Surgical trays","description":"Surgical trays","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31624","name":"Dx bronchoscope/lavage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","date_of_service":"2026-06-05","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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"27768","name":"Cltx post ankle fx w/mnpj","description":"Closed treatment of posterior malleolus fracture; with manipulation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-06-05","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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3265","name":"Plastazote sandal each","description":"Plastazote sandal, each","date_of_service":"2026-06-05","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":"21920","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35536","name":"Art byp grft splenorenal","description":"Bypass graft, with vein; splenorenal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92358","name":"Aphakia prosth service temp","description":"Prosthesis service for aphakia, temporary (disposable or loan, including materials)","date_of_service":"2026-06-05","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":"35231","name":"Repair blvsl vn grf neck","description":"Repair blood vessel with vein graft; neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27831","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"A6200","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86711","name":"John cunningham antibody","description":"Antibody; jc (john cunningham) virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","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":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-06-05","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":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0421T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88325","name":"Consltj compre rvw rec reprt","description":"Consultation, comprehensive, with review of records and specimens, with report on referred material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4550","name":"Surgical trays","description":"Surgical trays","date_of_service":"2026-06-05","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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27305","name":"Incise thigh tendon & fascia","description":"Fasciotomy, iliotibial (tenotomy), open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35256","name":"Repair blvsl vn grf lxtr","description":"Repair blood vessel with vein graft; lower extremity","date_of_service":"2026-06-05","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":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-06-05","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":"99340","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-05","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":"36861","name":"Cannula declotting","description":"External cannula declotting (separate procedure); with balloon catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90819","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-06-05","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":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15175","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"T4524","name":"Adult size brief/diaper xl","description":"Adult sized disposable incontinence product, brief/diaper, extra large, each","date_of_service":"2026-06-05","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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"58900","name":"Biopsy of ovary(s)","description":"Biopsy of ovary, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32422","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75680","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S3819","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86243","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-05","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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-06-05","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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-06-05","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":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-06-05","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":"96103","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-05","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":"56820","name":"Colposcopy vulva","description":"Colposcopy of the vulva;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"45170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29899","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-06-05","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":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","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":"64822","name":"Sympathectomy ulnar artery","description":"Sympathectomy; ulnar artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"99173","name":"Visual acuity screen","description":"Screening test of visual acuity, quantitative, bilateral","date_of_service":"2026-06-05","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":"A4232","name":"Syringe w/needle insulin 3cc","description":"Syringe with needle for external insulin pump, sterile, 3 cc","date_of_service":"2026-06-05","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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-06-05","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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-05","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":"21452","name":"Perq tx mndblr fx xtrnl fixj","description":"Percutaneous treatment of mandibular fracture, with external fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49565","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"0148T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35741","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33692","name":"Comp rpr tof wo pulm atresia","description":"Complete repair tetralogy of fallot without pulmonary atresia;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"33411","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"E0247","name":"Trans bench w/wo comm open","description":"Transfer bench for tub or toilet with or without commode opening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86606","name":"Aspergillus antibody","description":"Antibody; aspergillus","date_of_service":"2026-06-05","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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4918","name":"Venous pressure clamp","description":"Venous pressure clamp, for hemodialysis, each","date_of_service":"2026-06-05","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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"43205","name":"Esophagus endoscopy/ligation","description":"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57105","name":"Biopsy vaginal mucosa xtnsv","description":"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"89230","name":"Collect sweat for test","description":"Sweat collection by iontophoresis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51795","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64787","name":"Implant nerve end","description":"Implantation of nerve end into bone or muscle (list separately in addition to neuroma excision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"32150","name":"Removal of lung lesion(s)","description":"Thoracotomy; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77079","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"92342","name":"Fit spectacles multifocal","description":"Fitting of spectacles, except for aphakia; multifocal, other than bifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37235","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82820","name":"Hemoglobin-oxygen affinity","description":"Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3701","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92326","name":"Replacement of contact lens","description":"Replacement of contact lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28055","name":"Neurectomy foot","description":"Neurectomy, intrinsic musculature of foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23900","name":"Interthoracoscplr amputation","description":"Interthoracoscapular amputation (forequarter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"34804","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-06-05","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":"82340","name":"Assay of calcium in urine","description":"Calcium; urine quantitative, timed specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32673","name":"Thoracoscopy w/thymus resect","description":"Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22523","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87910","name":"Nfct agt gntyp alys cmv","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); cytomegalovirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83505","name":"Assay total hydroxyproline","description":"Hydroxyproline; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-06-05","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":"A4627","name":"Spacer bag/reservoir","description":"Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-05","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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-05","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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43820","name":"Gastrojejunostomy wo vagotmy","description":"Gastrojejunostomy; without vagotomy","date_of_service":"2026-06-05","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":"27520","name":"Treat kneecap fracture","description":"Closed treatment of patellar fracture, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-06-05","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":"35631","name":"Bpg aor-celiac-msn-renal","description":"Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42","45"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP","MCRPPO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4397","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0171T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-06-05","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":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58940","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33602","name":"Closure of valve","description":"Closure of semilunar valve (aortic or pulmonary) by suture or patch","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-06-05","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":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-06-05","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":"24560","name":"Cltx hum epcndylr fx wo mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-05","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":"29904","name":"Subtalar arthro w/fb rmvl","description":"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-06-05","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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-05","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":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"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":"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":"2026-06-05","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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90911","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"28226","name":"Release of foot tendons","description":"Tenolysis, extensor, foot; multiple tendons","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-05","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":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49082","name":"Abd paracentesis","description":"Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82190","name":"Atomic absorption","description":"Atomic absorption spectroscopy, each analyte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35471","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-06-05","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":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-05","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":"61610","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0430","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25170","name":"Resect radius/ulnar tumor","description":"Radical resection of tumor, radius or ulna","date_of_service":"2026-06-05","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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A9500","name":"Tc99m sestamibi","description":"Technetium tc-99m sestamibi, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1825","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29740","name":"Wedging of cast","description":"Wedging of cast (except clubfoot casts)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-06-05","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":"48001","name":"Placement of drain pancreas","description":"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29010","name":"Appl risser jacket body only","description":"Application of risser jacket, localizer, body; only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59320","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; vaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-06-05","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":"M0239","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20101","name":"Expl pentrg wound chest","description":"Exploration of penetrating wound (separate procedure); chest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90465","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"58340","name":"Catheter for hysterography","description":"Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28490","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33415","name":"Revision subvalvular tissue","description":"Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G9143","name":"Warfarin respon genetic test","description":"Warfarin responsiveness testing by genetic technique using any method, any number of specimen(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28294","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"0232T","name":"Njx platelet plasma","description":"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61610","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-06-05","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":"92984","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-05","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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-05","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":"90818","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"30118","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27659","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-06-05","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":"35305","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-05","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":"27442","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee;","date_of_service":"2026-06-05","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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28635","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84203","name":"Test rbc protoporphyrin","description":"Protoporphyrin, rbc; screen","date_of_service":"2026-06-05","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":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-06-05","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":"82486","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-06-05","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":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21077","name":"Impres&prep orbital prosth","description":"Impression and custom preparation; orbital prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61875","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1760","name":"Closure dev, vasc","description":"Closure device, vascular (implantable/insertable)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-06-05","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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-05","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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49655","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-06-05","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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-05","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":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15820","name":"Blepharoplasty lower eyelid","description":"Blepharoplasty, lower eyelid;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L1520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86378","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0456","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-06-05","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65750","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in aphakia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","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":"45563","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury; with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84585","name":"Assay of urine vma","description":"Vanillylmandelic acid (vma), urine","date_of_service":"2026-06-05","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":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99145","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-06-05","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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","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":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64565","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54164","name":"Frenulotomy of penis","description":"Frenulotomy of penis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-06-05","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":"86226","name":"Dna antibody single strand","description":"Deoxyribonucleic acid (dna) antibody; single stranded","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-06-05","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":"44960","name":"Appendectomy","description":"Appendectomy; for ruptured appendix with abscess or generalized peritonitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99226","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82252","name":"Fecal bilirubin test","description":"Bilirubin; feces, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"40510","name":"Partial excision of lip","description":"Excision of lip; transverse wedge excision with primary closure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47570","name":"Laparo cholecystoenterostomy","description":"Laparoscopy, surgical; cholecystoenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-05","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L8010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67112","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54865","name":"Explore epididymis","description":"Exploration of epididymis, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"89235","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95979","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"99143","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-05","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":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-05","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":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"42509","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with excision of both submandibular glands","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-06-05","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":"44393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","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":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"87621","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-06-05","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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3250","name":"Custom mold shoe remov prost","description":"Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"41105","name":"Biopsy of tongue","description":"Biopsy of tongue; posterior one-third","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"44901","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"68325","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"60220","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"0232T","name":"Njx platelet plasma","description":"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8265","name":"Haberman feeder","description":"Haberman feeder for cleft lip/palate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4529","name":"Ped size brief/diaper sm/med","description":"Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90999","name":"Unlisted dialysis procedure","description":"Unlisted dialysis procedure, inpatient or outpatient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.45,"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82376","name":"Assay carboxyhb qual","description":"Carboxyhemoglobin; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67041","name":"Vit for macular pucker","description":"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25400","name":"Repair radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; without graft (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"41500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21497","name":"Interdental wirg oth/thn fx","description":"Interdental wiring, for condition other than fracture","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"63199","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33814","name":"Obltrj a-pulm sep def w/byp","description":"Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","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":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-06-05","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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-06-05","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":"59136","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82671","name":"Assay of estrogens","description":"Estrogens; fractionated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-06-05","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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-05","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":"35450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-05","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":"59135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95065","name":"Dir nsl mucous membrane test","description":"Direct nasal mucous membrane test","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"96103","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32852","name":"Lung transplant with bypass","description":"Lung transplant, single; with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"83887","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30118","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-05","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":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51525","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0356T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29889","name":"Arthrs aid pcl rpr/agmntj","description":"Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01180","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-06-05","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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92533","name":"Caloric vestibular test","description":"Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32605","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24006","name":"Arthrt elbw capsl exc rls","description":"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V5010","name":"Assessment for hearing aid","description":"Assessment for hearing aid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1887","name":"Catheter, guiding","description":"Catheter, guiding (may include infusion/perfusion capability)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83858","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35493","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","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":["AU","AV"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-05","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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93236","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88740","name":"Transcutaneous carboxyhb","description":"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin","date_of_service":"2026-06-05","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":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-06-05","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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-06-05","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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43328","name":"Esoph fundoplasty thor","description":"Esophagogastric fundoplasty partial or complete; thoracotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-06-05","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":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-05","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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84110","name":"Assay of porphobilinogen","description":"Porphobilinogen, urine; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-05","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":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-06-05","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":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-05","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":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86860","name":"Rbc antibody elution","description":"Antibody elution (rbc), each elution","date_of_service":"2026-06-05","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":"75724","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"24579","name":"Optx humrl cndylr fracture","description":"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36260","name":"Insertion of infusion pump","description":"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60280","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","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":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35180","name":"Rpr cgen av fistula head&nck","description":"Repair, congenital arteriovenous fistula; head and neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-06-05","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":"28088","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; extensor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88271","name":"Cytogenetics dna probe","description":"Molecular cytogenetics; dna probe, each (eg, fish)","date_of_service":"2026-06-05","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":"47765","name":"Fuse liver ducts & bowel","description":"Anastomosis, of intrahepatic ducts and gastrointestinal tract","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50947","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11760","name":"Repair of nail bed","description":"Repair of nail bed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86406","name":"Particle agglut antbdy titr","description":"Particle agglutination; titer, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-06-05","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":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99340","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-06-05","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":"A4208","name":"3 cc sterile syringe&needle","description":"Syringe with needle, sterile 3 cc, each","date_of_service":"2026-06-05","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":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"32550","name":"Insert pleural cath","description":"Insertion of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-06-05","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":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86922","name":"Compatibility test antiglob","description":"Compatibility test each unit; antiglobulin technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-06-05","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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-05","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":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23184","name":"Prtl excision bone prox hum","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), proximal humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88375","name":"Optical endomicroscpy interp","description":"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session","date_of_service":"2026-06-05","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-05","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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33762","name":"Shunt desc aorta to pulm art","description":"Shunt; descending aorta to pulmonary artery (potts-smith type operation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"69676","name":"Remove middle ear nerve","description":"Tympanic neurectomy","date_of_service":"2026-06-05","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":"65820","name":"Goniotomy","description":"Goniotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"40804","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64627","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"80102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44010","name":"Incision of small bowel","description":"Duodenotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-05","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":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69320","name":"Rebuild outer ear canal","description":"Reconstruction external auditory canal for congenital atresia, single stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-06-05","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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-05","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":"89130","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26060","name":"Incision of finger tendon","description":"Tenotomy, percutaneous, single, each digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-06-05","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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-06-05","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":"45825","name":"Repair fistula w/colostomy","description":"Closure of rectourethral fistula; with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-05","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95075","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"96153","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"15175","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-06-05","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":"25490","name":"Prophylactic tx radius","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"49582","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30906","name":"Repeat control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28575","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","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":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53520","name":"Repair of urethra defect","description":"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21454","name":"Optx mndblr fx xtrnl fixj","description":"Open treatment of mandibular fracture with external fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"58570","name":"Tlh uterus 250 g or less","description":"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29916","name":"Hip arthro w/labral repair","description":"Arthroscopy, hip, surgical; with labral repair","date_of_service":"2026-06-05","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-06-05","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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-05","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43328","name":"Esoph fundoplasty thor","description":"Esophagogastric fundoplasty partial or complete; thoracotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86631","name":"Chlamydia antibody","description":"Antibody; chlamydia","date_of_service":"2026-06-05","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31296","name":"Nsl/sins ndsc surg frnt sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostium","date_of_service":"2026-06-05","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":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-06-05","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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93235","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"69222","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43204","name":"Esoph scope w/sclerosis inj","description":"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-05","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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33946","name":"Ecmo/ecls initiation venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-venous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32405","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"42508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53230","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45340","name":"Sig w/tndsc balloon dilation","description":"Sigmoidoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-05","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":"38205","name":"Harvest allogeneic stem cell","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-05","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":"96373","name":"Ther/proph/diag inj ia","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54015","name":"I&d penis deep","description":"Incision and drainage of penis, deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64722","name":"Decompression unspec nerve","description":"Decompression; unspecified nerve(s) (specify)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84681","name":"Assay of c-peptide","description":"C-peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-05","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":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-05","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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-06-05","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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"64520","name":"N block lumbar/thoracic","description":"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","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":"35633","name":"Bpg ilio-mesenteric","description":"Bypass graft, with other than vein; ilio-mesenteric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40818","name":"Excise oral mucosa for graft","description":"Excision of mucosa of vestibule of mouth as donor graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51920","name":"Close bladder-uterus fistula","description":"Closure of vesicouterine fistula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53060","name":"Drainage of urethra abscess","description":"Drainage of skenes gland abscess or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-05","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":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-06-05","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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65140","name":"Attach ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles attached to implant","date_of_service":"2026-06-05","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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37600","name":"Ligation xtrnl carotid art","description":"Ligation; external carotid artery","date_of_service":"2026-06-05","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":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75995","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-05","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":"31527","name":"Laryngoscopy for treatment","description":"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator","date_of_service":"2026-06-05","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":"90857","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0246T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47900","name":"Suture bile duct injury","description":"Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"57296","name":"Revise vag graft open abd","description":"Revision (including removal) of prosthetic vaginal graft; open abdominal approach","date_of_service":"2026-06-05","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":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-06-05","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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-06-05","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":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-05","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":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32408","name":"Core ndl bx lng/med perq","description":"Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-06-05","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":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27562","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-05","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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-06-05","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":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-05","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":"21920","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; superficial","date_of_service":"2026-06-05","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":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61783","name":"Scan proc spinal","description":"Stereotactic computer-assisted (navigational) procedure; spinal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-05","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":"21076","name":"Impres&prep surg obt prosth","description":"Impression and custom preparation; surgical obturator prosthesis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15770","name":"Derma-fat-fascia graft","description":"Graft; derma-fat-fascia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32402","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63655","name":"Implant neuroelectrodes","description":"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-05","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":"43244","name":"Egd varices ligation","description":"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-06-05","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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-05","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":"36000","name":"Place needle in vein","description":"Introduction of needle or intracatheter, vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32820","name":"Reconstruct injured chest","description":"Major reconstruction, chest wall (posttraumatic)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-05","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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52327","name":"Cystoscopy inject material","description":"Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29914","name":"Hip arthro w/femoroplasty","description":"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75724","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50394","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-06-05","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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-06-05","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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20924","name":"Removal of tendon for graft","description":"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83003","name":"Assay growth hormone (hgh)","description":"Growth hormone, human (hgh) (somatotropin)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-06-05","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":"31320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"26665","name":"Treat thumb fracture","description":"Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), includes internal fixation, when performed","date_of_service":"2026-06-05","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":"25415","name":"Repair radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; without graft (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10007","name":"Fna bx w/fluor gdn 1st les","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-05","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":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"19324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20694","name":"Rmvl ext fixj sys under anes","description":"Removal, under anesthesia, of external fixation system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36515","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0505","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-06-05","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":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"38221","name":"Dx bone marrow biopsies","description":"Diagnostic bone marrow; biopsy(ies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87517","name":"Hepatitis b dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","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":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87652","name":"Strep a dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, quantification","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-06-05","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":"31085","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-06-05","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":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53080","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; uncomplicated (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0269T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-06-05","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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27724","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-06-05","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31781","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervicothoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-06-05","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":"49904","name":"Omental flap extra-abdom","description":"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"20665","name":"Rmvl tongs/halo anthr indiv","description":"Removal of tongs or halo applied by another individual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","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":"86850","name":"Rbc antibody screen","description":"Antibody screen, rbc, each serum technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27161","name":"Incision of neck of femur","description":"Osteotomy, femoral neck (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-06-05","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":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-06-05","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":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"22220","name":"Osteot dsc ant 1 vrt sgm crv","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69718","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27516","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92015","name":"Determine refractive state","description":"Determination of refractive state","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21215","name":"Lower jaw bone graft","description":"Graft, bone; mandible (includes obtaining graft)","date_of_service":"2026-06-05","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":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-06-05","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":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"47382","name":"Percut ablate liver rf","description":"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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]}]},{"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":"2026-06-05","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":"86906","name":"Bld typing serologic rh phnt","description":"Blood typing, serologic; rh phenotyping, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25246","name":"Injection for wrist x-ray","description":"Injection procedure for wrist arthrography","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"38242","name":"Transplt allo lymphocytes","description":"Allogeneic lymphocyte infusions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85441","name":"Heinz bodies direct","description":"Heinz bodies; direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86709","name":"Hepatitis a igm antibody","description":"Hepatitis a antibody (haab), igm antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64614","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"32940","name":"Revision of lung","description":"Pneumonolysis, extraperiosteal, including filling or packing procedures","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-05","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":"59871","name":"Remove cerclage suture","description":"Removal of cerclage suture under anesthesia (other than local)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-06-05","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":"90802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35216","name":"Rpr blvsl dir ntrthrc wo byp","description":"Repair blood vessel, direct; intrathoracic, without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","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":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75676","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-06-05","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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84134","name":"Assay of prealbumin","description":"Prealbumin","date_of_service":"2026-06-05","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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-05","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84410","name":"Testosterone bioavailable","description":"Testosterone; bioavailable, direct measurement (eg, differential precipitation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83902","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51102","name":"Drain bl w/cath insertion","description":"Aspiration of bladder; with insertion of suprapubic catheter","date_of_service":"2026-06-05","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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-06-05","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":"33203","name":"Insert epicard eltrd endo","description":"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)","date_of_service":"2026-06-05","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":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","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":"87480","name":"Candida dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, direct probe technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93235","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4098","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-06-05","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":"32602","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11901","name":"Inject skin lesions >7","description":"Injection, intralesional; more than 7 lesions","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"87809","name":"Adenovirus assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41015","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual","date_of_service":"2026-06-05","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":"41116","name":"Excision of mouth lesion","description":"Excision, lesion of floor of mouth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33261","name":"Ablate heart dysrhythm focus","description":"Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-05","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-06-05","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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-06-05","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":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"30110","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25530","name":"Cltx ulnar shft fx w/o mnpj","description":"Closed treatment of ulnar shaft fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87275","name":"Influenza b ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza b virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20956","name":"Iliac bone graft microvasc","description":"Bone graft with microvascular anastomosis; iliac crest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69711","name":"Remove/repair hearing aid","description":"Removal or repair of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-05","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":"75671","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","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":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-05","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":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32405","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33820","name":"Repair pda by ligation","description":"Repair of patent ductus arteriosus; by ligation","date_of_service":"2026-06-05","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":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G9678","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"48540","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; roux-en-y","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"CPT","billing_code_type_version":"2026","billing_code":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54360","name":"Penis plastic surgery","description":"Plastic operation on penis to correct angulation","date_of_service":"2026-06-05","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":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61546","name":"Removal of pituitary gland","description":"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"31612","name":"Perq trchl pnxr ttrach aspir","description":"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22902","name":"Exc abd les sc < 3 cm","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82360","name":"Calculus assay quant","description":"Calculus; quantitative analysis, chemical","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42180","name":"Repair lac palate<2 cm","description":"Repair, laceration of palate; up to 2 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20245","name":"Bone biopsy open deep","description":"Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47800","name":"Reconstruction of bile ducts","description":"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27161","name":"Incision of neck of femur","description":"Osteotomy, femoral neck (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11771","name":"Exc pilonidal cyst xtnsv","description":"Excision of pilonidal cyst or sinus; extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"85366","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); paracoagulation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93555","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87515","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63190","name":"Incise spine nrv >2 segmnts","description":"Laminectomy with rhizotomy; more than 2 segments","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26670","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia","date_of_service":"2026-06-05","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-05","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-06-05","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":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23040","name":"Arthrt gh jt expl/drg/rmv fb","description":"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0452","name":"Molecular pathology interpr","description":"Molecular pathology procedure; physician interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30150","name":"Rhinectomy partial","description":"Rhinectomy; partial","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-06-05","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":"37761","name":"Ligate leg veins open","description":"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26820","name":"Thumb fusion with graft","description":"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-06-05","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":"90815","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37766","name":"Phleb veins - extrem 20+","description":"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"11971","name":"Rmvl tis xpndr wo insj implt","description":"Removal of tissue expander without insertion of implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-06-05","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":"27829","name":"Treat lower leg joint","description":"Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-05","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":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-05","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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4248","name":"Chlorhexidine antisept","description":"Chlorhexidine containing antiseptic, 1 ml","date_of_service":"2026-06-05","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":"24066","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9507","name":"In111 capromab","description":"Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63706","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; larger than 5 cm diameter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90801","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31530","name":"Laryngoscopy w/fb removal","description":"Laryngoscopy, direct, operative, with foreign body removal;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-06-05","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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-06-05","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":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82190","name":"Atomic absorption","description":"Atomic absorption spectroscopy, each analyte","date_of_service":"2026-06-05","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":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31531","name":"Laryngoscopy w/fb & op scope","description":"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope","date_of_service":"2026-06-05","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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"59121","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-06-05","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":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"M0223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4490","name":"Above knee surgical stocking","description":"Surgical stockings above knee length, each","date_of_service":"2026-06-05","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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"33945","name":"Transplantation of heart","description":"Heart transplant, with or without recipient cardiectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4269","name":"Spermicide","description":"Contraceptive supply, spermicide (e.g., foam, gel), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50947","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-05","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":"24153","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-06-05","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":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-06-05","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":"27702","name":"Reconstruct ankle joint","description":"Arthroplasty, ankle; with implant (total ankle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-06-05","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":"84490","name":"Assay of feces for trypsin","description":"Trypsin; feces, quantitative, 24-hour collection","date_of_service":"2026-06-05","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":"54420","name":"Revision of penis","description":"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-06-05","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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32665","name":"Thoracoscop w/esoph musc exc","description":"Thoracoscopy, surgical; with esophagomyotomy (heller type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28193","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4575","name":"Hyperbaric o2 chamber disps","description":"Topical hyperbaric oxygen chamber, disposable","date_of_service":"2026-06-05","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":"G0434","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27033","name":"Arthrt hip expl/rmv loose/fb","description":"Arthrotomy, hip, including exploration or removal of loose or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33221","name":"Insert pulse gen mult leads","description":"Insertion of pacemaker pulse generator only; with existing multiple leads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84480","name":"Assay triiodothyronine (t3)","description":"Triiodothyronine t3; total (tt-3)","date_of_service":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"39531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33967","name":"Insert i-aort percut device","description":"Insertion of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82103","name":"Alpha-1-antitrypsin total","description":"Alpha-1-antitrypsin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43810","name":"Gastroduodenostomy","description":"Gastroduodenostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-05","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":"28635","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33217","name":"Insert 2 electrode pm-defib","description":"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","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":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"L3701","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"32141","name":"Remove/treat lung lesions","description":"Thoracotomy; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35721","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"31588","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53505","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; penile","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60605","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; with excision of carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57100","name":"Biopsy vaginal mucosa simple","description":"Biopsy of vaginal mucosa; simple (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0144","name":"Azithromycin dihydrate, oral","description":"Azithromycin dihydrate, oral, capsules/powder, 1 gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","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":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-06-05","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":"28606","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-06-05","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":"0198T","name":"Ocular blood flow measure","description":"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4268","name":"Female condom","description":"Contraceptive supply, condom, female, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6025","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0439","name":"Ppps, subseq visit","description":"Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-06-05","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":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"CPT","billing_code_type_version":"2026","billing_code":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-06-05","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":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-06-05","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"59136","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86753","name":"Protozoa antibody nos","description":"Antibody; protozoa, not elsewhere specified","date_of_service":"2026-06-05","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"64573","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27087","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","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":"61305","name":"Crnec/crnot expl infratntorl","description":"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-05","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":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-06-05","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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50782","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of duplicated ureter to bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23620","name":"Cltx gr hmrl tbrs fx wo mnpj","description":"Closed treatment of greater humeral tuberosity fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-06-05","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":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"CPT","billing_code_type_version":"2026","billing_code":"31591","name":"Laryngoplasty medialization","description":"Laryngoplasty, medialization, unilateral","date_of_service":"2026-06-05","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":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-06-05","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":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45130","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; perineal approach","date_of_service":"2026-06-05","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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-06-05","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","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":"31527","name":"Laryngoscopy for treatment","description":"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-05","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":"67810","name":"Incal bx eyelid skn lid mrgn","description":"Incisional biopsy of eyelid skin including lid margin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77370","name":"Radiation physics consult","description":"Special medical radiation physics consultation","date_of_service":"2026-06-05","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":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27333","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial and lateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28310","name":"Revision of big toe","description":"Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)","date_of_service":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"27332","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial or lateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45550","name":"Repair rectum/remove sigmoid","description":"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach","date_of_service":"2026-06-05","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":"39530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-05","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":"42808","name":"Excise pharynx lesion","description":"Excision or destruction of lesion of pharynx, any method","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23466","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-06-05","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":"28250","name":"Revision of foot fascia","description":"Division of plantar fascia and muscle (eg, steindler stripping) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4719","name":"Y set tubing","description":"Y set tubing for peritoneal dialysis","date_of_service":"2026-06-05","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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-06-05","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":"22224","name":"Osteot dsc ant 1vrt sgm lmbr","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29873","name":"Arthrs knee surg w/lat rls","description":"Arthroscopy, knee, surgical; with lateral release","date_of_service":"2026-06-05","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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64680","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27001","name":"Tenotomy adductor hip open","description":"Tenotomy, adductor of hip, open","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62292","name":"Njx chemonucleolysis lmbr","description":"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0245","name":"Tub stool or bench","description":"Tub stool or bench","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90824","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","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":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0297T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28100","name":"Removal of ankle/heel lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-06-05","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":"29058","name":"Appl cast plaster velpeau","description":"Application, cast; plaster velpeau","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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":"27075","name":"Resect hip tumor","description":"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"22305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-05","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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-06-05","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":"67318","name":"Revise eye muscle(s)","description":"Strabismus surgery, any procedure, superior oblique muscle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0455","name":"Fecal microbiota prep instil","description":"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32095","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-06-05","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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30220","name":"Insert nasal septal button","description":"Insertion, nasal septal prosthesis (button)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"M0244","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"57000","name":"Colpotomy w/exploration","description":"Colpotomy; with exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"44020","name":"Explore small intestine","description":"Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86778","name":"Toxoplasma antibody igm","description":"Antibody; toxoplasma, igm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-06-05","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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-06-05","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":"83898","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"45170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81285","name":"Fxn gene charac alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-06-05","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":"86765","name":"Rubeola antibody","description":"Antibody; rubeola","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49521","name":"Rerepair ing hernia blocked","description":"Repair recurrent inguinal hernia, any age; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-06-05","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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"21347","name":"Opn tx nasomax fx multple","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); requiring multiple open approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-05","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":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-06-05","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":"0197T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"35509","name":"Art byp grft contral carotid","description":"Bypass graft, with vein; carotid-contralateral carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3918","name":"Metacarp fx orthosis pre ots","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-06-05","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":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-05","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":"23921","name":"Disarticulation sho sec clsr","description":"Disarticulation of shoulder; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83498","name":"Asy hydroxyprogesterone 17-d","description":"Hydroxyprogesterone, 17-d","date_of_service":"2026-06-05","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":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-05","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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-05","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":"92603","name":"Cochlear implt f/up exam 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; with programming","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51100","name":"Drain bladder by needle","description":"Aspiration of bladder; by needle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"32095","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36825","name":"Artery-vein autograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92563","name":"Tone decay hearing test","description":"Tone decay test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32662","name":"Thoracoscopy w/mediast exc","description":"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0111","name":"Wet mounts/ w preparations","description":"Wet mounts, including preparations of vaginal, cervical or skin specimens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-06-05","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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78593","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-05","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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-05","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":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-05","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":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26705","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-06-05","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":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21080","name":"Impres&prep def obt prosth","description":"Impression and custom preparation; definitive obturator prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-06-05","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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"23515","name":"Optx clavicular fx w/int fix","description":"Open treatment of clavicular fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31040","name":"Exploration behind upper jaw","description":"Pterygomaxillary fossa surgery, any approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82143","name":"Amniotic fluid scan","description":"Amniotic fluid scan (spectrophotometric)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25300","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; flexors of fingers","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G2063","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37619","name":"Ligation of inf vena cava","description":"Ligation of inferior vena cava","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"CPT","billing_code_type_version":"2026","billing_code":"58321","name":"Artificial insemination","description":"Artificial insemination; intra-cervical","date_of_service":"2026-06-05","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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L1815","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4928","name":"Surgical mask","description":"Surgical mask, per 20","date_of_service":"2026-06-05","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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0148T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26551","name":"Great toe-hand transfer","description":"Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28341","name":"Resect enlarged toe","description":"Reconstruction, toe, macrodactyly; requiring bone resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","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":"80150","name":"Assay of amikacin","description":"Amikacin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-05","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":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"60512","name":"Autotransplant parathyroid","description":"Parathyroid autotransplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-06-05","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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-06-05","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":"20979","name":"Lw ntsty us stimj bone healg","description":"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30115","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), extensive","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-05","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":"80157","name":"Assay carbamazepine free","description":"Carbamazepine; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-06-05","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":"0144A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82492","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"48001","name":"Placement of drain pancreas","description":"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-05","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43760","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","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":"29440","name":"Adding walker to prev cast","description":"Adding walker to previously applied cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71060","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67903","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57426","name":"Revise prosth vag graft lap","description":"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28445","name":"Optx talus fracture","description":"Open treatment of talus fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0103","name":"Psa screening","description":"Prostate cancer screening; prostate specific antigen test (psa)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44345","name":"Revision of colostomy","description":"Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"90868","name":"Tcranial magn stim tx deli","description":"Therapeutic repetitive transcranial magnetic stimulation (tms) treatment; subsequent delivery and management, per session","date_of_service":"2026-06-05","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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35626","name":"Bpg aor-subcla/innom/carotid","description":"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-05","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":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-05","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":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43268","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-05","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":"93542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","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":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"14300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-06-05","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":"A4306","name":"Drug delivery system <=50 ml","description":"Disposable drug delivery system, flow rate of less than 50 ml per hour","date_of_service":"2026-06-05","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":"57111","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-06-05","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":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"0034A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0497T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"T4539","name":"Reuse diaper/brief any size","description":"Incontinence product, diaper/brief, reusable, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58974","name":"Embryo transfer intrauterine","description":"Embryo transfer, intrauterine","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32656","name":"Thoracoscopy w/pleurectomy","description":"Thoracoscopy, surgical; with parietal pleurectomy","date_of_service":"2026-06-05","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":"S8424","name":"Ready gradient sleeve","description":"Gradient pressure aid (sleeve), ready made","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"19303","name":"Mast simple complete","description":"Mastectomy, simple, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-06-05","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":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4554","name":"Disposable underpads","description":"Disposable underpads, all sizes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-06-05","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":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-06-05","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":"P9016","name":"Rbc leukocytes reduced","description":"Red blood cells, leukocytes reduced, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27870","name":"Fusion of ankle joint open","description":"Arthrodesis, ankle, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42182","name":"Repair palate","description":"Repair, laceration of palate; over 2 cm or complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28805","name":"Amputation thru metatarsal","description":"Amputation, foot; transmetatarsal","date_of_service":"2026-06-05","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":"29065","name":"Appl cst sho to hand lng arm","description":"Application, cast; shoulder to hand (long arm)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57220","name":"Revision of urethra","description":"Plastic operation on urethral sphincter, vaginal approach (eg, kelly urethral plication)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15756","name":"Free myo/skin flap microvasc","description":"Free muscle or myocutaneous flap with microvascular anastomosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-06-05","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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4657","name":"Syringe w/wo needle","description":"Syringe, with or without needle, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36147","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"26340","name":"Manipulate finger w/anesth","description":"Manipulation, finger joint, under anesthesia, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-05","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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","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":"50785","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with vesico-psoas hitch or bladder flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35482","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85246","name":"Clot factor viii vw antigen","description":"Clotting; factor viii, vw factor antigen","date_of_service":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28230","name":"Incision of foot tendon(s)","description":"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45172","name":"Exc rect tum transanal full","description":"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","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":"15950","name":"Exc trchntr pr ulc prim sutr","description":"Excision, trochanteric pressure ulcer, with primary suture;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-05","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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82646","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-05","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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49062","name":"Drain to peritoneal cavity","description":"Drainage of extraperitoneal lymphocele to peritoneal cavity, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1758","name":"Catheter, ureteral","description":"Catheter, ureteral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54680","name":"Relocation of testis(es)","description":"Transplantation of testis(es) to thigh (because of scrotal destruction)","date_of_service":"2026-06-05","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":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-05","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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85536","name":"Iron stain peripheral blood","description":"Iron stain, peripheral blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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":"57020","name":"Colpocentesis sep px","description":"Colpocentesis (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"44661","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; with intestine and/or bladder resection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35761","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43265","name":"Ercp lithotripsy calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32603","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-06-05","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":"41112","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; anterior two-thirds","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.0,"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5266","name":"Battery for hearing device","description":"Battery for use in hearing device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-05","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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51940","name":"Correction of bladder defect","description":"Closure, exstrophy of bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33641","name":"Repair heart septum defect","description":"Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-06-05","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":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99364","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-05","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":"A9277","name":"External transmitter, cgm","description":"Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system","date_of_service":"2026-06-05","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":"64613","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27087","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31000","name":"Irrigation maxillary sinus","description":"Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)","date_of_service":"2026-06-05","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":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45339","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31239","name":"Nsl/sinus endoscopy surg dcr","description":"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65756","name":"Corneal trnspl endothelial","description":"Keratoplasty (corneal transplant); endothelial","date_of_service":"2026-06-05","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-05","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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-06-05","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":"43272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-06-05","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":"35616","name":"Bpg subclavian-axillary","description":"Bypass graft, with other than vein; subclavian-axillary","date_of_service":"2026-06-05","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":"25215","name":"Removal of wrist bones","description":"Carpectomy; all bones of proximal row","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83662","name":"Foam stability fetal lung","description":"Fetal lung maturity assessment; foam stability test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90467","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"83735","name":"Assay of magnesium","description":"Magnesium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"59100","name":"Remove uterus lesion","description":"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22212","name":"Incis 1 vertebral seg thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83993","name":"Assay for calprotectin fecal","description":"Calprotectin, fecal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45108","name":"Anorectal myomectomy","description":"Anorectal myomectomy","date_of_service":"2026-06-05","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":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61711","name":"Fusion of skull arteries","description":"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"0013A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-06-05","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":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"H0001","name":"Alcohol and/or drug assess","description":"Alcohol and/or drug assessment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33282","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35494","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86003","name":"Allg spec ige crude xtrc ea","description":"Allergen specific ige; quantitative or semiquantitative, crude allergen extract, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-06-05","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":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27760","name":"Cltx medial ankle fx","description":"Closed treatment of medial malleolus fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57550","name":"Removal of residual cervix","description":"Excision of cervical stump, vaginal approach;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"44227","name":"Lap close enterostomy","description":"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis","date_of_service":"2026-06-05","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":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58661","name":"Laparoscopy remove adnexa","description":"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27594","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; secondary closure or scar revision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47136","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27193","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"97003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-05","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":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-06-05","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":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"47765","name":"Fuse liver ducts & bowel","description":"Anastomosis, of intrahepatic ducts and gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83861","name":"Microfluid analy tears","description":"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43496","name":"Free jejunum flap microvasc","description":"Free jejunum transfer with microvascular anastomosis","date_of_service":"2026-06-05","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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-06-05","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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-05","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":"69400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","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":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33617","name":"Repair single ventricle","description":"Repair of complex cardiac anomalies (eg, single ventricle) by modified fontan procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87279","name":"Parainfluenza ag if","description":"Infectious agent antigen detection by immunofluorescent technique; parainfluenza virus, each type","date_of_service":"2026-06-05","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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-05","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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G6022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"15321","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29345","name":"Application of long leg cast","description":"Application of long leg cast (thigh to toes);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33031","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"84315","name":"Body fluid specific gravity","description":"Specific gravity (except urine)","date_of_service":"2026-06-05","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":"64624","name":"Dstrj nulyt agt gnclr nrv","description":"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-06-05","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":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61330","name":"Dcmprn orbit only transcrnl","description":"Decompression of orbit only, transcranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4211","name":"Supp for self-adm injections","description":"Supplies for self-administered injections","date_of_service":"2026-06-05","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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64505","name":"N block spenopalatine gangl","description":"Injection, anesthetic agent; sphenopalatine ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","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":"61440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-06-05","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":"10009","name":"Fna bx w/ct gdn 1st les","description":"Fine needle aspiration biopsy, including ct guidance; first lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85300","name":"Antithrombin iii activity","description":"Clotting inhibitors or anticoagulants; antithrombin iii, activity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0171T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-06-05","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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11770","name":"Exc pilonidal cyst simple","description":"Excision of pilonidal cyst or sinus; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67950","name":"Revision of eyelid","description":"Canthoplasty (reconstruction of canthus)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","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":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-06-05","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":"21280","name":"Medial canthopexy","description":"Medial canthopexy (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35535","name":"Art byp grft hepatorenal","description":"Bypass graft, with vein; hepatorenal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"96003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-06-05","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4770","name":"Blood collection tube/vacuum","description":"Blood collection tube, vacuum, for dialysis, per 50","date_of_service":"2026-06-05","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":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64510","name":"N block stellate ganglion","description":"Injection, anesthetic agent; stellate ganglion (cervical sympathetic)","date_of_service":"2026-06-05","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":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-06-05","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":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-05","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":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","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":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-06-05","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":"15336","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-06-05","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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33416","name":"Revise ventricle muscle","description":"Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-06-05","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":"25151","name":"Partial removal of radius","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50392","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-06-05","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":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25100","name":"Biopsy of wrist joint","description":"Arthrotomy, wrist joint; with biopsy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36471","name":"Njx sclrsnt mlt incmptnt vn","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","date_of_service":"2026-06-05","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":"89330","name":"Evaluation cervical mucus","description":"Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58953","name":"Tah rad dissect for debulk","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-06-05","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":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29740","name":"Wedging of cast","description":"Wedging of cast (except clubfoot casts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-06-05","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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-05","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":"51720","name":"Treatment of bladder lesion","description":"Bladder instillation of anticarcinogenic agent (including retention time)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-06-05","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":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69970","name":"Remove inner ear lesion","description":"Removal of tumor, temporal bone","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59130","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; abdominal pregnancy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57426","name":"Revise prosth vag graft lap","description":"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-06-05","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":"A4670","name":"Automatic bp monitor, dial","description":"Automatic blood pressure monitor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49553","name":"Rpr fem hernia init blocked","description":"Repair initial femoral hernia, any age; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G6018","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28192","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31400","name":"Revision of larynx","description":"Arytenoidectomy or arytenoidopexy, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77422","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-06-05","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":"69421","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42215","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; major revision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86376","name":"Microsomal antibody each","description":"Microsomal antibodies (eg, thyroid or liver-kidney), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4270","name":"Disposable endoscope sheath","description":"Disposable endoscope sheath, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-05","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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26542","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-05","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":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-06-05","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":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33020","name":"Incision of heart sac","description":"Pericardiotomy for removal of clot or foreign body (primary procedure)","date_of_service":"2026-06-05","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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42720","name":"I&d absc phrngl ntraorl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-05","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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"43101","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84035","name":"Assay of phenylketones","description":"Phenylketones, qualitative","date_of_service":"2026-06-05","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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-05","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":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27170","name":"Repair/graft femur head/neck","description":"Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51772","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41251","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; posterior one-third of tongue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57555","name":"Remove cervix/repair vagina","description":"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-06-05","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":"50045","name":"Nephrotomy w/exploration","description":"Nephrotomy, with exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-06-05","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":"S4989","name":"Contracept iud","description":"Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39502","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-06-05","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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82307","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-06-05","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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87804","name":"Influenza assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; influenza","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"31367","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, without radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75724","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-05","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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-06-05","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":"94370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82136","name":"Amino acids quant 2-5","description":"Amino acids, 2 to 5 amino acids, quantitative, each specimen","date_of_service":"2026-06-05","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":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25136","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45300","name":"Proctosigmoidoscopy dx","description":"Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19301","name":"Partial mastectomy","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43204","name":"Esoph scope w/sclerosis inj","description":"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32480","name":"Partial removal of lung","description":"Removal of lung, other than pneumonectomy; single lobe (lobectomy)","date_of_service":"2026-06-05","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":"61612","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66180","name":"Aqueous shunt eye w/graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11720","name":"Debride nail 1-5","description":"Debridement of nail(s) by any method(s); 1 to 5","date_of_service":"2026-06-05","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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20956","name":"Iliac bone graft microvasc","description":"Bone graft with microvascular anastomosis; iliac crest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L4210","name":"Orth dev repair/repl minor p","description":"Repair of orthotic device, repair or replace minor parts","date_of_service":"2026-06-05","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-05","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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-05","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-05","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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20808","name":"Replantation hand complete","description":"Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50240","name":"Nephrectomy partial","description":"Nephrectomy, partial","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-06-05","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":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"87277","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83582","name":"Assay of ketogenic steroids","description":"Ketogenic steroids, fractionation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63200","name":"Release spinal cord lumbar","description":"Laminectomy, with release of tethered spinal cord, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37600","name":"Ligation xtrnl carotid art","description":"Ligation; external carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61321","name":"Crnec/crnot drg icr abs ittl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial","date_of_service":"2026-06-05","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":"35303","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; popliteal artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31582","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76498","name":"Unlisted mr procedure","description":"Unlisted magnetic resonance procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-06-05","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":"83661","name":"L/s ratio fetal lung","description":"Fetal lung maturity assessment; lecithin sphingomyelin (l/s) ratio","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G9686","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43210","name":"Egd esophagogastrc fndoplsty","description":"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed","date_of_service":"2026-06-05","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":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-05","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":"30130","name":"Excise inferior turbinate","description":"Excision inferior turbinate, partial or complete, any method","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"80196","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"62140","name":"Crnop skull defect<5 cm diam","description":"Cranioplasty for skull defect; up to 5 cm diameter","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85292","name":"Clot factor fletcher fact","description":"Clotting; prekallikrein assay (fletcher factor assay)","date_of_service":"2026-06-05","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":"43206","name":"Esoph optical endomicroscopy","description":"Esophagoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28436","name":"Prq skel fix talus fx w/mnpj","description":"Percutaneous skeletal fixation of talus fracture, with manipulation","date_of_service":"2026-06-05","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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"S0610","name":"Annual gynecological examina","description":"Annual gynecological examination, new patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27687","name":"Revision of calf tendon","description":"Gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-06-05","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":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","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":"99201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19300","name":"Mastectomy for gynecomastia","description":"Mastectomy for gynecomastia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83491","name":"Asy hydroxycorticosteroids17","description":"Hydroxycorticosteroids, 17- (17-ohcs)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-06-05","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":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-05","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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28054","name":"Biopsy of toe joint lining","description":"Arthrotomy with biopsy; interphalangeal joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36145","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67911","name":"Revise eyelid defect","description":"Correction of lid retraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83919","name":"Organic acids qual each","description":"Organic acids; qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49657","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77413","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25150","name":"Partial removal of ulna","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86360","name":"T cell absolute count/ratio","description":"T cells; absolute cd4 and cd8 count, including ratio","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"63173","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-06-05","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":"80502","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27200","name":"Treat tail bone fracture","description":"Closed treatment of coccygeal fracture","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4670","name":"Automatic bp monitor, dial","description":"Automatic blood pressure monitor","date_of_service":"2026-06-05","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":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"82820","name":"Hemoglobin-oxygen affinity","description":"Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)","date_of_service":"2026-06-05","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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54437","name":"Repair corporeal tear","description":"Repair of traumatic corporeal tear(s)","date_of_service":"2026-06-05","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":"69530","name":"Extensive mastoid surgery","description":"Petrous apicectomy including radical mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-05","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":"92130","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"00622","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00452","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-05","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":"G6012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-05","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":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50785","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with vesico-psoas hitch or bladder flap","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33475","name":"Replacement pulmonary valve","description":"Replacement, pulmonary valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-06-05","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":"L3649","name":"Orthopedic shoe modifica nos","description":"Orthopedic shoe, modification, addition or transfer, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33788","name":"Revision of pulmonary artery","description":"Reimplantation of an anomalous pulmonary artery","date_of_service":"2026-06-05","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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27680","name":"Release of lower leg tendon","description":"Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94610","name":"Intrapulm surfactant admn","description":"Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41010","name":"Incision of tongue fold","description":"Incision of lingual frenum (frenotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43305","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90829","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-05","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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"26551","name":"Great toe-hand transfer","description":"Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around with bone graft","date_of_service":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"A4266","name":"Diaphragm","description":"Diaphragm for contraceptive use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-06-05","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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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":"53270","name":"Removal of urethra gland","description":"Excision or fulguration; skenes glands","date_of_service":"2026-06-05","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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50650","name":"Removal of ureter","description":"Ureterectomy, with bladder cuff (separate procedure)","date_of_service":"2026-06-05","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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49906","name":"Free omental flap microvasc","description":"Free omental flap with microvascular anastomosis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37207","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21440","name":"Cltx mndblr/max alv ridge fx","description":"Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-06-05","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":"63615","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"38792","name":"Ra tracer id of sentinl node","description":"Injection procedure; radioactive tracer for identification of sentinel node","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21387","name":"Opn tx orbit fx combined","description":"Open treatment of orbital floor blowout fracture; combined approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29893","name":"Endoscopic plantr fasciotomy","description":"Endoscopic plantar fasciotomy","date_of_service":"2026-06-05","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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"B4222","name":"Parenteral supply kit homemi","description":"Parenteral nutrition supply kit; home mix, per day","date_of_service":"2026-06-05","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":"26260","name":"Resect prox finger tumor","description":"Radical resection of tumor, proximal or middle phalanx of finger","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-05","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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"A7043","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53854","name":"Trurl dstrj prst8 tiss rf wv","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","date_of_service":"2026-06-05","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":"27269","name":"Optx thigh fx","description":"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-05","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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86336","name":"Inhibin a","description":"Inhibin a","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"30905","name":"Control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-06-05","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":"11100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77417","name":"Ther radiology port image(s)","description":"Therapeutic radiology port image(s)","date_of_service":"2026-06-05","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":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-06-05","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":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30620","name":"Intranasal reconstruction","description":"Septal or other intranasal dermatoplasty (does not include obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-06-05","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":"86817","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, multiple antigens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-06-05","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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-06-05","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":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0424","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84302","name":"Assay of sweat sodium","description":"Sodium; other source","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28476","name":"Prq skel fix metar fx w/mnpj","description":"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4270","name":"Disposable endoscope sheath","description":"Disposable endoscope sheath, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-05","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":"A4929","name":"Tourniquet for dialysis, ea","description":"Tourniquet for dialysis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"32096","name":"Open wedge/bx lung infiltr","description":"Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-06-05","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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3485","name":"Shoe heel pad removable for","description":"Heel, pad, removable for spur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"40720","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"37205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15934","name":"Exc sacral pr ulc skn flap","description":"Excision, sacral pressure ulcer, with skin flap closure;","date_of_service":"2026-06-05","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":"A4605","name":"Trach suction cath close sys","description":"Tracheal suction catheter, closed system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88720","name":"Bilirubin total transcut","description":"Bilirubin, total, transcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"19295","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27687","name":"Revision of calf tendon","description":"Gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50120","name":"Pyelotomy w/exploration","description":"Pyelotomy; with exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-05","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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32110","name":"Explore/repair chest","description":"Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear","date_of_service":"2026-06-05","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":"G9141","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77083","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43206","name":"Esoph optical endomicroscopy","description":"Esophagoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84445","name":"Assay of tsi globulin","description":"Thyroid stimulating immune globulins (tsi)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53446","name":"Remove uro sphincter","description":"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4244","name":"Alcohol or peroxide per pint","description":"Alcohol or peroxide, per pint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44135","name":"Intestine transplnt cadaver","description":"Intestinal allotransplantation; from cadaver donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0504","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-06-05","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":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-05","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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46030","name":"Removal anal seton oth mrk","description":"Removal of anal seton, other marker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50548","name":"Laparo remove w/ureter","description":"Laparoscopy, surgical; nephrectomy with total ureterectomy","date_of_service":"2026-06-05","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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"35450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"26756","name":"Pin finger fracture each","description":"Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each","date_of_service":"2026-06-05","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":"90814","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A9561","name":"Tc99m oxidronate","description":"Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82810","name":"Blood gases o2 sat only","description":"Gases, blood, o2 saturation only, by direct measurement, except pulse oximetry","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-06-05","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":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-06-05","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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-05","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":"68811","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4927","name":"Non-sterile gloves","description":"Gloves, non-sterile, per 100","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29582","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67950","name":"Revision of eyelid","description":"Canthoplasty (reconstruction of canthus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"37607","name":"Lig/banding angioacs av fstl","description":"Ligation or banding of angioaccess arteriovenous fistula","date_of_service":"2026-06-05","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-06-05","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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-06-05","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":"43272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"CPT","billing_code_type_version":"2026","billing_code":"42408","name":"Excision of salivary cyst","description":"Excision of sublingual salivary cyst (ranula)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"57240","name":"Anterior colporrhaphy","description":"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"00452","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-05","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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85525","name":"Heparin neutralization","description":"Heparin neutralization","date_of_service":"2026-06-05","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":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-05","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":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-06-05","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":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-05","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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"32662","name":"Thoracoscopy w/mediast exc","description":"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"23397","name":"Muscle transfers","description":"Muscle transfer, any type, shoulder or upper arm; multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-06-05","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":"37619","name":"Ligation of inf vena cava","description":"Ligation of inferior vena cava","date_of_service":"2026-06-05","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":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-06-05","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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-05","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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-05","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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25924","name":"Amputation follow-up surgery","description":"Disarticulation through wrist; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-06-05","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":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-06-05","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":"22212","name":"Incis 1 vertebral seg thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","date_of_service":"2026-06-05","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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87101","name":"Skin fungi culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail","date_of_service":"2026-06-05","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":"46937","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90813","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-05","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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67346","name":"Biopsy eye muscle","description":"Biopsy of extraocular muscle","date_of_service":"2026-06-05","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":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-06-05","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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15825","name":"Rhytdct nck pltysml tghtg","description":"Rhytidectomy; neck with platysmal tightening (platysmal flap, p-flap)","date_of_service":"2026-06-05","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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5010","name":"Assessment for hearing aid","description":"Assessment for hearing aid","date_of_service":"2026-06-05","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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-06-05","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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67036","name":"Removal of inner eye fluid","description":"Vitrectomy, mechanical, pars plana approach;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38382","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; abdominal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-06-05","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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-05","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":"26756","name":"Pin finger fracture each","description":"Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86880","name":"Coombs test direct","description":"Antihuman globulin test (coombs test); direct, each antiserum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-06-05","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":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90468","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","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":"21495","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26645","name":"Treat thumb fracture","description":"Closed treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-05","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3257","name":"Orth foot add charge split s","description":"Orthopedic footwear, additional charge for split size","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85415","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen activator","date_of_service":"2026-06-05","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":"58275","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"42810","name":"Excision of neck cyst","description":"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33877","name":"Thoracoabdominal graft","description":"Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-06-05","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":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","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":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35637","name":"Bpg aortoiliac","description":"Bypass graft, with other than vein; aortoiliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93529","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-06-05","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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-06-05","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":"60240","name":"Removal of thyroid","description":"Thyroidectomy, total or complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-05","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":"65781","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99335","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82397","name":"Chemiluminescent assay","description":"Chemiluminescent assay","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"75665","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"87197","name":"Serum bactericidal titer","description":"Serum bactericidal titer (schlichter test)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0092","name":"Set up port xray equipment","description":"Set-up portable x-ray equipment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0515","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"51500","name":"Removal of bladder cyst","description":"Excision of urachal cyst or sinus, with or without umbilical hernia repair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"23515","name":"Optx clavicular fx w/int fix","description":"Open treatment of clavicular fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23130","name":"Acromp/acromionectomy prtl","description":"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"27331","name":"Explore/treat knee joint","description":"Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-06-05","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":"90810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77403","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"10140","name":"I&d hmtma seroma/fluid collj","description":"Incision and drainage of hematoma, seroma or fluid collection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92564","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-05","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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64804","name":"Sympathectomy cervicothorac","description":"Sympathectomy, cervicothoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33285","name":"Insj subq car rhythm mntr","description":"Insertion, subcutaneous cardiac rhythm monitor, including programming","date_of_service":"2026-06-05","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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-05","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":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15732","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92984","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-06-05","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":"78268","name":"Urea breath test c-14 alys","description":"Urea breath test, c-14 (isotopic); analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"36416","name":"Collj capillary blood spec","description":"Collection of capillary blood specimen (eg, finger, heel, ear stick)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53250","name":"Removal of urethra gland","description":"Excision of bulbourethral gland (cowpers gland)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82642","name":"Dihydrotestosterone","description":"Dihydrotestosterone (dht)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83873","name":"Assay of csf protein","description":"Myelin basic protein, cerebrospinal fluid","date_of_service":"2026-06-05","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":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"B4164","name":"Parenteral 50% dextrose solu","description":"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"46700","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; adult","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40801","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23466","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27727","name":"Repair of lower leg","description":"Repair of congenital pseudarthrosis, tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64823","name":"Sympathectomy supfc palmar","description":"Sympathectomy; superficial palmar arch","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-05","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":"86316","name":"Immunoassay tumor other","description":"Immunoassay for tumor antigen, other antigen, quantitative (eg, ca 50, 72-4, 549), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27030","name":"Arthrotomy hip w/drainage","description":"Arthrotomy, hip, with drainage (eg, infection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81327","name":"Sept9 gen prmtr mthyltn alys","description":"Sept9 (septin9) (eg, colorectal cancer) promoter methylation analysis","date_of_service":"2026-06-05","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":"19305","name":"Mast radical","description":"Mastectomy, radical, including pectoral muscles, axillary lymph nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31395","name":"Reconstruct larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; with reconstruction","date_of_service":"2026-06-05","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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L1500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0071A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42509","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with excision of both submandibular glands","date_of_service":"2026-06-05","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":"64470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-06-05","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":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1893","name":"Intro/sheath, fixed,non-peel","description":"Introducer/sheath, guiding, intracardiac electrophysiological, fixed-curve, other than peel-away","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-05","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"26910","name":"Amputate metacarpal bone","description":"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37221","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-06-05","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":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96373","name":"Ther/proph/diag inj ia","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial","date_of_service":"2026-06-05","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-05","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"65290","name":"Repair of eye socket wound","description":"Repair of wound, extraocular muscle, tendon and/or tenons capsule","date_of_service":"2026-06-05","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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-06-05","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":"15335","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-05","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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-05","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":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"T4528","name":"Adult size pull-on xl","description":"Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29280","name":"Strapping of hand or finger","description":"Strapping; hand or finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-06-05","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"E0190","name":"Positioning cushion","description":"Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0355T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-06-05","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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-05","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":"E0700","name":"Safety equipment","description":"Safety equipment, device or accessory, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93524","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64573","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"81274","name":"Htt gene charac alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"58925","name":"Removal of ovarian cyst(s)","description":"Ovarian cystectomy, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","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":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-06-05","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":"95832","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31805","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; intrathoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86256","name":"Fluorescent antibody titer","description":"Fluorescent noninfectious agent antibody; titer, each antibody","date_of_service":"2026-06-05","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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0493T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83901","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3212","name":"Benesch boot pair infant","description":"Benesch boot, pair, infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-05","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":"99443","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-06-05","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":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"54440","name":"Repair of penis","description":"Plastic operation of penis for injury","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"99082","name":"Unusual physician travel","description":"Unusual travel (eg, transportation and escort of patient)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45400","name":"Laparoscopic proc","description":"Laparoscopy, surgical; proctopexy (for prolapse)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49010","name":"Exploration behind abdomen","description":"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3203","name":"Oxford w/ supinator/pronator","description":"Orthopedic shoe, oxford with supinator or pronator, junior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"99339","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64566","name":"Neuroeltrd stim post tibial","description":"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming","date_of_service":"2026-06-05","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":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3222","name":"Mens shoes hightop depth inl","description":"Orthopedic footwear, mens shoe, hightop, depth inlay, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30600","name":"Repair mouth/nose fistula","description":"Repair fistula; oronasal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31580","name":"Laryngoplasty laryngeal web","description":"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion","date_of_service":"2026-06-05","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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"41017","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-05","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":"90997","name":"Hemoperfusion","description":"Hemoperfusion (eg, with activated charcoal or resin)","date_of_service":"2026-06-05","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":"69710","name":"Implant/replace hearing aid","description":"Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61001","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-06-05","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":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"46261","name":"Remove in/ex hem grps & fiss","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"92517","name":"Vemp test i&r cervical","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp)","date_of_service":"2026-06-05","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":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"66165","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92564","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-06-05","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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-06-05","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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"68328","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29800","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90466","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"H0047","name":"Alcohol/drug abuse svc nos","description":"Alcohol and/or other drug abuse services, not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26440","name":"Release palm/finger tendon","description":"Tenolysis, flexor tendon; palm or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21084","name":"Impres&prep sp aid prosth","description":"Impression and custom preparation; speech aid prosthesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-06-05","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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26477","name":"Tendon shortening","description":"Shortening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32540","name":"Removal of lung lesion","description":"Extrapleural enucleation of empyema (empyemectomy)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-05","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":"G0102","name":"Prostate ca screening; dre","description":"Prostate cancer screening; digital rectal examination","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-05","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":"L7272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83695","name":"Assay of lipoprotein(a)","description":"Lipoprotein (a)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32815","name":"Close bronchial fistula","description":"Open closure of major bronchial fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82946","name":"Glucagon tolerance test","description":"Glucagon tolerance test","date_of_service":"2026-06-05","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":"82540","name":"Assay of creatine","description":"Creatine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"E1340","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33282","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-05","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-06-05","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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-05","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":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86337","name":"Insulin antibodies","description":"Insulin antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-06-05","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":"A4575","name":"Hyperbaric o2 chamber disps","description":"Topical hyperbaric oxygen chamber, disposable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-06-05","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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"40842","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21188","name":"Reconstruction of midface","description":"Reconstruction midface, osteotomies (other than lefort type) and bone grafts (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-06-05","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":"67314","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92602","name":"Reprogram cochlear implt <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-06-05","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":"27132","name":"Total hip arthroplasty","description":"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11752","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"38100","name":"Removal of spleen total","description":"Splenectomy; total (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","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":"A7523","name":"Tracheostomy shower protect","description":"Tracheostomy shower protector, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-06-05","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":"21800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84588","name":"Assay of vasopressin","description":"Vasopressin (antidiuretic hormone, adh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69745","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-05","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":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G2012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28605","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32607","name":"Thoracoscopy w/bx infiltrate","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-05","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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-06-05","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":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-05","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":"91000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"15838","name":"Exc excsv submental fat pad","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"96912","name":"Photochemotherapy puva","description":"Photochemotherapy; psoralens and ultraviolet a (puva)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33813","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80154","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0154A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32905","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"99326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44050","name":"Reduce bowel obstruction","description":"Reduction of volvulus, intussusception, internal hernia, by laparotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"63182","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86765","name":"Rubeola antibody","description":"Antibody; rubeola","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54438","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99356","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"60225","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-05","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":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-06-05","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":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"84138","name":"Assay of pregnanetriol","description":"Pregnanetriol","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"11740","name":"Evacuation subungual hmtma","description":"Evacuation of subungual hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"96158","name":"Hlth bhv ivntj indiv 1st 30","description":"Health behavior intervention, individual, face-to-face; initial 30 minutes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43281","name":"Lap paraesophag hern repair","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0144","name":"Azithromycin dihydrate, oral","description":"Azithromycin dihydrate, oral, capsules/powder, 1 gram","date_of_service":"2026-06-05","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":"21127","name":"Augmentation mndblr b1 grf","description":"Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-06-05","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":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-06-05","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":"32554","name":"Aspirate pleura w/o imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-06-05","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-05","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":"B4105","name":"Enzyme cartridge enteral nut","description":"In-line cartridge containing digestive enzyme(s) for enteral feeding, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4660","name":"Sphyg/bp app w cuff and stet","description":"Sphygmomanometer/blood pressure apparatus with cuff and stethoscope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58673","name":"Laparoscopy salpingostomy","description":"Laparoscopy, surgical; with salpingostomy (salpingoneostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21268","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48153","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-06-05","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":"43855","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"25695","name":"Optx lunate dislocation","description":"Open treatment of lunate dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54500","name":"Biopsy of testis","description":"Biopsy of testis, needle (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","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":"42405","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; incisional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4245","name":"Alcohol wipes per box","description":"Alcohol wipes, per box","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63180","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-06-05","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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-05","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":"45990","name":"Surg dx exam anorectal","description":"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic","date_of_service":"2026-06-05","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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10509","10512","10516","10524","10537","10541","10542","10579","10910","10912","10914","10915","10916","10917","10918","10919","10921","10922","10924","10925","10926","10928","10930","10932","10933","10940","10941","10943","10949","10950","10953","10958","10959","10963","10969","10973","10975","10979","10981","10985","10987","10988","10990","10992","10996","10997","10998","12015","12017","12029","12037","12042","12050","12051","12058","12060","12075","12083","12087","12106","12115","12124","12125","12130","12132","12136","12165","12167","12172","12173","12174","12176","12184","12192","12195","12401","12402","12404","12405","12406","12407","12409","12410","12411","12412","12413","12414","12416","12417","12418","12419","12420","12421","12422","12423","12424","12427","12428","12429","12430","12431","12432","12433","12434","12435","12436","12438","12439","12440","12441","12442","12443","12444","12446","12448","12449","12450","12451","12452","12453","12454","12455","12456","12457","12458","12459","12460","12461","12463","12464","12465","12466","12468","12470","12471","12472","12473","12474","12475","12477","12480","12481","12482","12483","12484","12485","12486","12487","12489","12490","12491","12492","12493","12494","12495","12496","12498","12501","12502","12503","12504","12506","12507","12508","12510","12511","12512","12513","12514","12515","12516","12517","12518","12520","12521","12522","12523","12524","12525","12526","12527","12528","12529","12530","12531","12533","12534","12537","12538","12540","12541","12542","12543","12544","12545","12546","12547","12548","12549","12550","12551","12552","12553","12555","12561","12563","12564","12565","12566","12567","12568","12569","12570","12571","12572","12574","12575","12577","12578","12580","12581","12582","12583","12584","12585","12586","12588","12589","12590","12592","12593","12594","12601","12602","12603","12604","12701","12719","12720","12721","12722","12723","12724","12725","12726","12727","12729","12732","12733","12734","12736","12737","12738","12740","12741","12742","12743","12745","12746","12747","12748","12749","12750","12751","12752","12754","12758","12759","12760","12762","12763","12764","12765","12766","12767","12768","12769","12770","12771","12775","12776","12777","12778","12779","12780","12781","12782","12783","12784","12785","12786","12787","12788","12789","12790","12791","12792","13731","13739","13740","13750","13751","13752","13753","13755","13756","13757","13774","13775","13782","13783","13786","13788","13804","13806","13837","13838","13839","13842","13846","13847","13856","13860"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"S3818","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-05","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":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"0421T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86200","name":"Ccp antibody","description":"Cyclic citrullinated peptide (ccp), antibody","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-06-05","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":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-06-05","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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25628","name":"Optx carpl scphd fx int fixj","description":"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83914","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-06-05","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":"96922","name":"Excimer lsr psriasis>500sqcm","description":"Excimer laser treatment for psoriasis; over 500 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4261","name":"Cervical cap contraceptive","description":"Cervical cap for contraceptive use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83695","name":"Assay of lipoprotein(a)","description":"Lipoprotein (a)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","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":["AU","AV"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-06-05","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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61330","name":"Dcmprn orbit only transcrnl","description":"Decompression of orbit only, transcranial approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58600","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50220","name":"Remove kidney open","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49610","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); first stage","date_of_service":"2026-06-05","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":"82172","name":"Assay of apolipoprotein","description":"Apolipoprotein, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87283","name":"Rubeola ag if","description":"Infectious agent antigen detection by immunofluorescent technique; rubeola","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54220","name":"Irrg crpra cavrnosa priapism","description":"Irrigation of corpora cavernosa for priapism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"T4527","name":"Adult size pull-on lg","description":"Adult sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-06-05","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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47630","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84203","name":"Test rbc protoporphyrin","description":"Protoporphyrin, rbc; screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28341","name":"Resect enlarged toe","description":"Reconstruction, toe, macrodactyly; requiring bone resection","date_of_service":"2026-06-05","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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28570","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; without anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0475","name":"Hiv combination assay","description":"Hiv antigen/antibody, combination assay, screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64821","name":"Sympathectomy radial artery","description":"Sympathectomy; radial artery","date_of_service":"2026-06-05","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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75994","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65775","name":"Correction of astigmatism","description":"Corneal wedge resection for correction of surgically induced astigmatism","date_of_service":"2026-06-05","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":"61333","name":"Expl orbit w/removal lesion","description":"Exploration of orbit (transcranial approach), with removal of lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-05","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":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45905","name":"Dilation of anal sphincter","description":"Dilation of anal sphincter (separate procedure) under anesthesia other than local","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61340","name":"Subtemporal cranial dcmprn","description":"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"77079","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0485T","name":"Oct mid ear i&r unilateral","description":"Optical coherence tomography (oct) of middle ear, with interpretation and report; unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76497","name":"Unlisted ct procedure","description":"Unlisted computed tomography procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19110","name":"Nipple exploration","description":"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86886","name":"Coombs test indirect titer","description":"Antihuman globulin test (coombs test); indirect, each antibody titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89050","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;","date_of_service":"2026-06-05","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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","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":"33736","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; open heart with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"46608","name":"Anoscopy remove for body","description":"Anoscopy; with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94240","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"99185","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35207","name":"Rpr bld vsl dir hand finger","description":"Repair blood vessel, direct; hand, finger","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21820","name":"Treat sternum fracture","description":"Closed treatment of sternum fracture","date_of_service":"2026-06-05","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":"43401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"A7042","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"41872","name":"Gingivoplasty each quadrant","description":"Gingivoplasty, each quadrant (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63707","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28225","name":"Release of foot tendon","description":"Tenolysis, extensor, foot; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51980","name":"Construct bladder opening","description":"Cutaneous vesicostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3219","name":"Orthopedic mens shoes oxford","description":"Orthopedic footwear, mens shoe, oxford, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82139","name":"Amino acids quan 6 or more","description":"Amino acids, 6 or more amino acids, quantitative, each specimen","date_of_service":"2026-06-05","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":"20962","name":"Other bone graft microvasc","description":"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82978","name":"Assay of glutathione","description":"Glutathione","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-05","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":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99354","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54162","name":"Lysis penil circumic lesion","description":"Lysis or excision of penile post-circumcision adhesions","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21700","name":"Revision of neck muscle","description":"Division of scalenus anticus; without resection of cervical rib","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-05","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-06-05","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":"37224","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10005","name":"Fna bx w/us gdn 1st les","description":"Fine needle aspiration biopsy, including ultrasound guidance; first lesion","date_of_service":"2026-06-05","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":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"67921","name":"Repair eyelid defect","description":"Repair of entropion; suture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33960","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-06-05","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35474","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93541","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-06-05","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":"62140","name":"Crnop skull defect<5 cm diam","description":"Cranioplasty for skull defect; up to 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-06-05","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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-06-05","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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"26255","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-05","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":"T4538","name":"Diaper serv reusable diaper","description":"Diaper service, reusable diaper, each diaper","date_of_service":"2026-06-05","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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-05","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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93526","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6512","name":"Compres burn garment, noc","description":"Compression burn garment, not otherwise classified","date_of_service":"2026-06-05","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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-05","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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75940","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29435","name":"Appl patllr tdn bearing cast","description":"Application of patellar tendon bearing (ptb) cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64585","name":"Rev/rmv perph nstim eltrd ra","description":"Revision or removal of peripheral neurostimulator electrode array","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-06-05","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":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-05","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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-05","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":"37785","name":"Ligate/divide/excise vein","description":"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","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":"A0425","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35472","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27603","name":"Drain lower leg lesion","description":"Incision and drainage, leg or ankle; deep abscess or hematoma","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-05","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":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0027","name":"Semen analysis","description":"Semen analysis; presence and/or motility of sperm excluding huhner","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-06-05","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":"G0444","name":"Depression screen annual","description":"Annual depression screening, 5 to 15 minutes","date_of_service":"2026-06-05","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33925","name":"Rpr pul art unifocal w/o cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass","date_of_service":"2026-06-05","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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-06-05","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":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"35551","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21123","name":"Geniop sldg augmentation","description":"Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53415","name":"Reconstruction of urethra","description":"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra","date_of_service":"2026-06-05","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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1751","name":"Cath, inf, per/cent/midline","description":"Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"78268","name":"Urea breath test c-14 alys","description":"Urea breath test, c-14 (isotopic); analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0422","name":"Intens cardiac rehab w/exerc","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33216","name":"Insert 1 electrode pm-defib","description":"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31575","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, flexible; diagnostic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86651","name":"Encephalitis californ antbdy","description":"Antibody; encephalitis, california (la crosse)","date_of_service":"2026-06-05","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":"49657","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77416","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87300","name":"Ag detection polyval if","description":"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82486","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-06-05","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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49654","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-05","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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"54231","name":"Dynamic cavernosometry","description":"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"35472","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86753","name":"Protozoa antibody nos","description":"Antibody; protozoa, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0248T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-06-05","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":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","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":"43245","name":"Egd dilate stricture","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"49021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28740","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, single joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43327","name":"Esoph fundoplasty lap","description":"Esophagogastric fundoplasty partial or complete; laparotomy","date_of_service":"2026-06-05","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":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-06-05","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":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-06-05","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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65771","name":"Radial keratotomy","description":"Radial keratotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"44136","name":"Intestine transplant live","description":"Intestinal allotransplantation; from living donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-06-05","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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-05","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":"54200","name":"Injection px peyronie ds","description":"Injection procedure for peyronie disease;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-05","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":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-06-05","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44208","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy","date_of_service":"2026-06-05","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":"92340","name":"Fit spectacles monofocal","description":"Fitting of spectacles, except for aphakia; monofocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87622","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-05","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":"A4490","name":"Above knee surgical stocking","description":"Surgical stockings above knee length, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22525","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-06-05","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":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42836","name":"Removal of adenoids","description":"Adenoidectomy, secondary; age 12 or over","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1760","name":"Closure dev, vasc","description":"Closure device, vascular (implantable/insertable)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54692","name":"Laparoscopy orchiopexy","description":"Laparoscopy, surgical; orchiopexy for intra-abdominal testis","date_of_service":"2026-06-05","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":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64911","name":"Neurorraphy w/vein autograft","description":"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99443","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5364","name":"Dysphagia screening","description":"Dysphagia screening","date_of_service":"2026-06-05","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":"41874","name":"Alveoloplasty each quadrant","description":"Alveoloplasty, each quadrant (specify)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82489","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4554","name":"Disposable underpads","description":"Disposable underpads, all sizes","date_of_service":"2026-06-05","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":"B4087","name":"Gastro/jejuno tube, std","description":"Gastrostomy/jejunostomy tube, standard, any material, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25170","name":"Resect radius/ulnar tumor","description":"Radical resection of tumor, radius or ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"58553","name":"Laparo-vag hyst complex","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-05","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":"21244","name":"Reconstruction of lower jaw","description":"Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)","date_of_service":"2026-06-05","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":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37617","name":"Ligation major artery abd","description":"Ligation, major artery (eg, post-traumatic, rupture); abdomen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-05","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":"25151","name":"Partial removal of radius","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44314","name":"Revision of ileostomy","description":"Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58294","name":"Vag hyst w/enterocele compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85536","name":"Iron stain peripheral blood","description":"Iron stain, peripheral blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7266","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0147T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35637","name":"Bpg aortoiliac","description":"Bypass graft, with other than vein; aortoiliac","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-05","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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-06-05","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":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35355","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliofemoral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","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":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-05","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":"0212T","name":"Compre audiometry evaluation","description":"Comprehensive audiometry threshold evaluation and speech recognition (0209t, 0211t combined), automated","date_of_service":"2026-06-05","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":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84220","name":"Assay of pyruvate kinase","description":"Pyruvate kinase","date_of_service":"2026-06-05","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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-06-05","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":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45114","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; abdominal and transsacral approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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 exam","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69433","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia","date_of_service":"2026-06-05","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":"75790","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-05","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":"L3202","name":"Oxford w/ supinat/pronator c","description":"Orthopedic shoe, oxford with supinator or pronator, child","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"37617","name":"Ligation major artery abd","description":"Ligation, major artery (eg, post-traumatic, rupture); abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86920","name":"Compatibility test spin","description":"Compatibility test each unit; immediate spin technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G6007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15819","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"48102","name":"Needle biopsy pancreas","description":"Biopsy of pancreas, percutaneous needle","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-05","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":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23625","name":"Cltx gr hmrl tbrs fx w/mnpj","description":"Closed treatment of greater humeral tuberosity fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4706","name":"Bicarbonate conc sol per gal","description":"Bicarbonate concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"H0016","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-06-05","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":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54380","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter;","date_of_service":"2026-06-05","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":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28173","name":"Resect metatarsal tumor","description":"Radical resection of tumor; metatarsal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"22852","name":"Remove spine fixation device","description":"Removal of posterior segmental instrumentation","date_of_service":"2026-06-05","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":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-05","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":"38571","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36011","name":"Place catheter in vein","description":"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)","date_of_service":"2026-06-05","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":"27086","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; subcutaneous tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-05","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":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"42961","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27427","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; extra-articular","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21750","name":"Repair of sternum separation","description":"Closure of median sternotomy separation with or without debridement (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0151T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35741","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75790","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43234","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-05","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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-06-05","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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31601","name":"Planned tracheostomy<2 yrs","description":"Tracheostomy, planned (separate procedure); younger than 2 years","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83505","name":"Assay total hydroxyproline","description":"Hydroxyproline; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-05","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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25441","name":"Arthrp w/prostc dstl rds","description":"Arthroplasty with prosthetic replacement; distal radius","date_of_service":"2026-06-05","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":"86860","name":"Rbc antibody elution","description":"Antibody elution (rbc), each elution","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00634","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51100","name":"Drain bladder by needle","description":"Aspiration of bladder; by needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90814","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["KL","NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25455","name":"Epiphysl arrst dstl rds&ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius and ulna","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27725","name":"Repair of lower leg","description":"Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27552","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80164","name":"Assay dipropylacetic acd tot","description":"Valproic acid (dipropylacetic acid); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43400","name":"Ligate esophagus veins","description":"Ligation, direct, esophageal varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43456","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88261","name":"Chromosome analysis 5","description":"Chromosome analysis; count 5 cells, 1 karyotype, with banding","date_of_service":"2026-06-05","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":"93508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0604","name":"Hosp grade elec breast pump","description":"Breast pump, hospital grade, electric (ac and / or dc), any type","date_of_service":"2026-06-05","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":"61682","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, complex","date_of_service":"2026-06-05","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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82633","name":"Desoxycorticosterone","description":"Desoxycorticosterone, 11-","date_of_service":"2026-06-05","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":"69436","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-06-05","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":"65820","name":"Goniotomy","description":"Goniotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92532","name":"Positional nystagmus test","description":"Positional nystagmus test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54865","name":"Explore epididymis","description":"Exploration of epididymis, with or without biopsy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-05","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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27001","name":"Tenotomy adductor hip open","description":"Tenotomy, adductor of hip, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64627","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27330","name":"Biopsy knee joint lining","description":"Arthrotomy, knee; with synovial biopsy only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36261","name":"Revision of infusion pump","description":"Revision of implanted intra-arterial infusion pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"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":"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":"2026-06-05","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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-06-05","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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-05","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":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28270","name":"Release of foot contracture","description":"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)","date_of_service":"2026-06-05","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":"36147","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"96151","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"47550","name":"Bile duct endoscopy add-on","description":"Biliary endoscopy, intraoperative (choledochoscopy) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35302","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; superficial femoral artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4648","name":"Implantable tissue marker","description":"Tissue marker, implantable, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49180","name":"Biopsy abdominal mass","description":"Biopsy, abdominal or retroperitoneal mass, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15835","name":"Exc excessive skin buttock","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86817","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, multiple antigens","date_of_service":"2026-06-05","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":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-06-05","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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-06-05","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":"88371","name":"Protein western blot tissue","description":"Protein analysis of tissue by western blot, with interpretation and report;","date_of_service":"2026-06-05","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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37227","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-06-05","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":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-06-05","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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-05","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38213","name":"Platelet deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; platelet depletion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64859","name":"Nerve surgery","description":"Suture of each additional major peripheral nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61305","name":"Crnec/crnot expl infratntorl","description":"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47136","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77409","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-06-05","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43647","name":"Lap impl electrode antrum","description":"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"58572","name":"Tlh uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61314","name":"Crnec/crnot ittl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-06-05","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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8680","name":"Implt neurostim elctr each","description":"Implantable neurostimulator electrode, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-06-05","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":"60200","name":"Remove thyroid lesion","description":"Excision of cyst or adenoma of thyroid, or transection of isthmus","date_of_service":"2026-06-05","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0343","name":"Laparotomy islet cell transp","description":"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-06-05","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":"49525","name":"Repair ing hernia sliding","description":"Repair inguinal hernia, sliding, any age","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43820","name":"Gastrojejunostomy wo vagotmy","description":"Gastrojejunostomy; without vagotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-06-05","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":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0241","name":"Bath tub wall rail","description":"Bath tub wall rail, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"52270","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; female","date_of_service":"2026-06-05","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":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35355","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-05","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":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0197T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69725","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; including medial to geniculate ganglion","date_of_service":"2026-06-05","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":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-05","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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"23156","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61250","name":"Burr hole/treph sttl expl","description":"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86821","name":"Lymphocyte culture mixed","description":"Hla typing; lymphocyte culture, mixed (mlc)","date_of_service":"2026-06-05","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":"78465","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4495","name":"Thigh length surg stocking","description":"Surgical stockings thigh length, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82941","name":"Assay of gastrin","description":"Gastrin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27665","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90813","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-06-05","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":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66990","name":"Ophthalmic endoscope add-on","description":"Use of ophthalmic endoscope (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-06-05","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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-05","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":"15823","name":"Blepharp upr eyelid xcsv skn","description":"Blepharoplasty, upper eyelid; with excessive skin weighting down lid","date_of_service":"2026-06-05","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":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-05","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":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11106","name":"Incal bx skn single les","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51920","name":"Close bladder-uterus fistula","description":"Closure of vesicouterine fistula;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93316","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-05","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":"35484","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26776","name":"Pin finger dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-06-05","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":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["66","02","81","32","13","56","31","06","51","61","07","19","05","23","41","21","26","52","49","65","42","24","22","33","10","08","53","34","18"],"billing_code_modifier":["93","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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0172T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"G0437","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-05","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":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"26740","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82943","name":"Assay of glucagon","description":"Glucagon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82926","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84120","name":"Assay of urine porphyrins","description":"Porphyrins, urine; quantitation and fractionation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33511","name":"Cabg vein two","description":"Coronary artery bypass, vein only; 2 coronary venous grafts","date_of_service":"2026-06-05","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":"33411","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"89140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-05","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":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-06-05","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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37227","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27705","name":"Osteotomy tibia","description":"Osteotomy; tibia","date_of_service":"2026-06-05","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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-05","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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"S8421","name":"Ready gradient sleev/glov","description":"Gradient pressure aid (sleeve and glove combination), ready made","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4932","name":"Reusable rectal thermometer","description":"Rectal thermometer, reusable, any type, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","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":"76880","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP06","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-06-05","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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57282","name":"Colpopexy extraperitoneal","description":"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64736","name":"Incision of chin nerve","description":"Transection or avulsion of; mental nerve","date_of_service":"2026-06-05","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":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90581","name":"Anthrax vaccine sc or im","description":"Anthrax vaccine, for subcutaneous or intramuscular use","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-06-05","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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-05","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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-06-05","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":"33031","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-06-05","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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-05","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":"A4590","name":"Special casting material","description":"Special casting material (e.g., fiberglass)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"49215","name":"Excise sacral spine tumor","description":"Excision of presacral or sacrococcygeal tumor","date_of_service":"2026-06-05","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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-06-05","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","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":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44382","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-06-05","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":"27235","name":"Treat thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, proximal end, neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44146","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy","date_of_service":"2026-06-05","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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83582","name":"Assay of ketogenic steroids","description":"Ketogenic steroids, fractionation","date_of_service":"2026-06-05","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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-06-05","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":"54205","name":"Njx px peyronie ds exps plaq","description":"Injection procedure for peyronie disease; with surgical exposure of plaque","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"82252","name":"Fecal bilirubin test","description":"Bilirubin; feces, qualitative","date_of_service":"2026-06-05","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":"64836","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; ulnar motor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-06-05","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":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"47561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","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":"G2064","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-06-05","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":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"80172","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"66150","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trephination with iridectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41800","name":"Drainage of gum lesion","description":"Drainage of abscess, cyst, hematoma from dentoalveolar structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"87107","name":"Fungi identification mold","description":"Culture, fungi, definitive identification, each organism; mold","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36469","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0207T","name":"Clear eyelid gland w/heat","description":"Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral","date_of_service":"2026-06-05","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":"36620","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47562","name":"Laparoscopic cholecystectomy","description":"Laparoscopy, surgical; cholecystectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"35606","name":"Bpg carotid-subclavian","description":"Bypass graft, with other than vein; carotid-subclavian","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50815","name":"Urine shunt to intestine","description":"Ureterocolon conduit, including intestine anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84146","name":"Assay of prolactin","description":"Prolactin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61253","name":"Burr hole treph ittl uni/bi","description":"Burr hole(s) or trephine, infratentorial, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92353","name":"Fit aphakia spectcl multifoc","description":"Fitting of spectacle prosthesis for aphakia; multifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"40701","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92992","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43648","name":"Lap revise/remv eltrd antrum","description":"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33404","name":"Prepare heart-aorta conduit","description":"Construction of apical-aortic conduit","date_of_service":"2026-06-05","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":"54435","name":"Revision of penis","description":"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, winter procedure, rongeur, or punch) for priapism","date_of_service":"2026-06-05","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":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-06-05","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":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-06-05","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":"G9044","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"32604","name":"Thoracoscopy wbx sac","description":"Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4772","name":"Blood glucose test strips","description":"Blood glucose test strips, for dialysis, per 50","date_of_service":"2026-06-05","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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["KL","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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66185","name":"Revise aqueous shunt eye","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-05","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":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-06-05","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":"40702","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-06-05","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":"75900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"01936","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-06-05","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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28730","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;","date_of_service":"2026-06-05","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-05","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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","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":"28088","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; extensor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44300","name":"Open bowel to skin","description":"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-06-05","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":"62328","name":"Dx lmbr spi pnxr w/fluor/ct","description":"Spinal puncture, lumbar, diagnostic; with fluoroscopic or ct guidance","date_of_service":"2026-06-05","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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-06-05","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":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44180","name":"Lap enterolysis","description":"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56420","name":"I&d bartholins gland abscess","description":"Incision and drainage of bartholins gland abscess","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32815","name":"Close bronchial fistula","description":"Open closure of major bronchial fistula","date_of_service":"2026-06-05","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":"61001","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"26685","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75960","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31288","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"62147","name":"Crnop w/autograft>5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter","date_of_service":"2026-06-05","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":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21138","name":"Rdctj forehead cntrg&prostc","description":"Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-05","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":"82145","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28430","name":"Cltx talus fracture w/o mnpj","description":"Closed treatment of talus fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15600","name":"Delay flap trunk","description":"Delay of flap or sectioning of flap (division and inset); at trunk","date_of_service":"2026-06-05","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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28055","name":"Neurectomy foot","description":"Neurectomy, intrinsic musculature of foot","date_of_service":"2026-06-05","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":"62141","name":"Crnop skull defect>5 cm diam","description":"Cranioplasty for skull defect; larger than 5 cm diameter","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82978","name":"Assay of glutathione","description":"Glutathione","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92640","name":"Aud brainstem implt programg","description":"Diagnostic analysis with programming of auditory brainstem implant, per hour","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46080","name":"Sphnctrotmy anal div sphnctr","description":"Sphincterotomy, anal, division of sphincter (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"44210","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy","date_of_service":"2026-06-05","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":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47122","name":"Extensive removal of liver","description":"Hepatectomy, resection of liver; trisegmentectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27893","name":"Decompression of leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-05","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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"36160","name":"Establish access to aorta","description":"Introduction of needle or intracatheter, aortic, translumbar","date_of_service":"2026-06-05","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-06-05","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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50340","name":"Recipient nephrectomy","description":"Recipient nephrectomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42330","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","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":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-06-05","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":"84235","name":"Assay of endocrine hormone","description":"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-05","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":"31528","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28240","name":"Release of big toe","description":"Tenotomy, lengthening, or release, abductor hallucis muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4211","name":"Supp for self-adm injections","description":"Supplies for self-administered injections","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"99145","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25390","name":"Shorten radius or ulna","description":"Osteoplasty, radius or ulna; shortening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61630","name":"Balo angioplasty icr perq","description":"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25685","name":"Optx trns-scphprlnr fx dislc","description":"Open treatment of trans-scaphoperilunar type of fracture dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24371","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"53665","name":"Dilation of urethra","description":"Dilation of female urethra, general or conduction (spinal) anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38770","name":"Remove pelvis lymph nodes","description":"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21088","name":"Impres&prep facial prosth","description":"Impression and custom preparation; facial prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28555","name":"Repair foot dislocation","description":"Open treatment of tarsal bone dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"44050","name":"Reduce bowel obstruction","description":"Reduction of volvulus, intussusception, internal hernia, by laparotomy","date_of_service":"2026-06-05","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-05","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":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"56633","name":"Vulvectomy radical complete","description":"Vulvectomy, radical, complete;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84445","name":"Assay of tsi globulin","description":"Thyroid stimulating immune globulins (tsi)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49572","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85345","name":"Coagulation time lee & white","description":"Coagulation time; lee and white","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88285","name":"Chromosome count additional","description":"Chromosome analysis; additional cells counted, each study","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-06-05","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-05","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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43245","name":"Egd dilate stricture","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)","date_of_service":"2026-06-05","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":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-06-05","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":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-06-05","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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25900","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-05","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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86486","name":"Skin test unlisted antign ea","description":"Skin test; unlisted antigen, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-05","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":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67835","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin, with free mucous membrane graft","date_of_service":"2026-06-05","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":"86689","name":"Htlv/hiv confirmj antibody","description":"Antibody; htlv or hiv antibody, confirmatory test (eg, western blot)","date_of_service":"2026-06-05","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":"21601","name":"Exc chest wall tumor w/ribs","description":"Excision of chest wall tumor including rib(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26075","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27445","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83951","name":"Oncoprotein dcp","description":"Oncoprotein; des-gamma-carboxy-prothrombin (dcp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83857","name":"Assay of methemalbumin","description":"Methemalbumin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-06-05","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":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","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":"69145","name":"Remove ear canal lesion(s)","description":"Excision soft tissue lesion, external auditory canal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83921","name":"Organic acid single quant","description":"Organic acid, single, quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-06-05","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":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"40800","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple","date_of_service":"2026-06-05","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":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-06-05","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":"84228","name":"Assay of quinine","description":"Quinine","date_of_service":"2026-06-05","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"22523","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27734","name":"Repair lower leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67101","name":"Repair detached retina crtx","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6639","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-06-05","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":"27181","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; osteotomy and internal fixation","date_of_service":"2026-06-05","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":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-06-05","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":"28190","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; subcutaneous","date_of_service":"2026-06-05","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":"63265","name":"Excise intraspinl lesion crv","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46606","name":"Anoscopy and biopsy","description":"Anoscopy; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G6011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-05","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":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-06-05","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":"37620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86920","name":"Compatibility test spin","description":"Compatibility test each unit; immediate spin technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-05","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":"27248","name":"Treat thigh fracture","description":"Open treatment of greater trochanteric fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82103","name":"Alpha-1-antitrypsin total","description":"Alpha-1-antitrypsin; total","date_of_service":"2026-06-05","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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"33889","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82085","name":"Assay of aldolase","description":"Aldolase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61692","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0504T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64402","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85366","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); paracoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28555","name":"Repair foot dislocation","description":"Open treatment of tarsal bone dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66605","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; with cyclectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35525","name":"Art byp grft brachial-brchl","description":"Bypass graft, with vein; brachial-brachial","date_of_service":"2026-06-05","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":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28435","name":"Cltx talus fracture w/mnpj","description":"Closed treatment of talus fracture; with manipulation","date_of_service":"2026-06-05","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":"82544","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"42450","name":"Excise sublingual gland","description":"Excision of sublingual gland","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31578","name":"Largsc w/removal lesion","description":"Laryngoscopy, flexible; with removal of lesion(s), non-laser","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"29280","name":"Strapping of hand or finger","description":"Strapping; hand or finger","date_of_service":"2026-06-05","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":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-06-05","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":"49084","name":"Peritoneal lavage","description":"Peritoneal lavage, including imaging guidance, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","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":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-06-05","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":"00622","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29025","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33284","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42971","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-06-05","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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43887","name":"Gstr rstcv px opn rmvl port","description":"Gastric restrictive procedure, open; removal of subcutaneous port component only","date_of_service":"2026-06-05","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":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42831","name":"Removal of adenoids","description":"Adenoidectomy, primary; age 12 or over","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33978","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-05","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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42320","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary, external","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"28003","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27870","name":"Fusion of ankle joint open","description":"Arthrodesis, ankle, open","date_of_service":"2026-06-05","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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-05","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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-06-05","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83912","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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":"0297T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46937","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23412","name":"Repair rotator cuff chronic","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-05","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":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33235","name":"Removal pacemaker electrode","description":"Removal of transvenous pacemaker electrode(s); dual lead system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27468","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"Q9955","name":"Inj perflexane lip micros,ml","description":"Injection, perflexane lipid microspheres, per ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23331","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87495","name":"Cytomeg dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, direct probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31032","name":"Explore sinus remove polyps","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) with removal of antrochoanal polyps","date_of_service":"2026-06-05","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":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-05","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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-06-05","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":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29515","name":"Application short leg splint","description":"Application of short leg splint (calf to foot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-06-05","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":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-06-05","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":"32603","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29445","name":"Appl rigid tot cntc leg cast","description":"Application of rigid total contact leg cast","date_of_service":"2026-06-05","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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20970","name":"Bone/skin graft iliac crest","description":"Free osteocutaneous flap with microvascular anastomosis; iliac crest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86038","name":"Antinuclear antibodies","description":"Antinuclear antibodies (ana);","date_of_service":"2026-06-05","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":"63276","name":"Bx/exc xdrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32605","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-05","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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64708","name":"Revise arm/leg nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-05","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":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-05","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":"82495","name":"Assay of chromium","description":"Chromium","date_of_service":"2026-06-05","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":"20005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63281","name":"Bx/exc idrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0540T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51535","name":"Repair of ureter lesion","description":"Cystotomy for excision, incision, or repair of ureterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"38207","name":"Cryopreserve stem cells","description":"Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0247T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2609","name":"Custom fabricate w/c cushion","description":"Custom fabricated wheelchair seat cushion, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"52204","name":"Cystoscopy w/biopsy(s)","description":"Cystourethroscopy, with biopsy(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-05","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"V5241","name":"Dispensing fee, monaural","description":"Dispensing fee, monaural hearing aid, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84119","name":"Test urine for porphyrins","description":"Porphyrins, urine; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"99177","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26100","name":"Biopsy hand joint lining","description":"Arthrotomy with biopsy; carpometacarpal joint, each","date_of_service":"2026-06-05","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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8499","name":"Unlisted misc prosthetic ser","description":"Unlisted procedure for miscellaneous prosthetic services","date_of_service":"2026-06-05","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":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82705","name":"Fats/lipids feces qual","description":"Fat or lipids, feces; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"19316","name":"Mastopexy","description":"Mastopexy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31040","name":"Exploration behind upper jaw","description":"Pterygomaxillary fossa surgery, any approach","date_of_service":"2026-06-05","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":"81120","name":"Idh1 common variants","description":"Idh1 (isocitrate dehydrogenase 1 [nadp+], soluble) (eg, glioma), common variants (eg, r132h, r132c)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-06-05","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":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","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":"29916","name":"Hip arthro w/labral repair","description":"Arthroscopy, hip, surgical; with labral repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"20926","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35570","name":"Art byp tibial-tib/peroneal","description":"Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial","date_of_service":"2026-06-05","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":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64736","name":"Incision of chin nerve","description":"Transection or avulsion of; mental nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","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":"80100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42450","name":"Excise sublingual gland","description":"Excision of sublingual gland","date_of_service":"2026-06-05","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":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-06-05","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":"28546","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27079","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-06-05","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":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27305","name":"Incise thigh tendon & fascia","description":"Fasciotomy, iliotibial (tenotomy), open","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"88262","name":"Chromosome analysis 15-20","description":"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62147","name":"Crnop w/autograft>5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27727","name":"Repair of lower leg","description":"Repair of congenital pseudarthrosis, tibia","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-06-05","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":"43496","name":"Free jejunum flap microvasc","description":"Free jejunum transfer with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25624","name":"Cltx carpl scphd fx w/mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"G9043","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82928","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"47785","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of intrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"C9113","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-06-05","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":"99441","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"56440","name":"Mrsplzatn brthlns glnd cst","description":"Marsupialization of bartholins gland cyst","date_of_service":"2026-06-05","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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-05","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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77031","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64653","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42409","name":"Drainage of salivary cyst","description":"Marsupialization of sublingual salivary cyst (ranula)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"C1879","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33961","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"35521","name":"Art byp grft axill-femoral","description":"Bypass graft, with vein; axillary-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31300","name":"Removal of larynx lesion","description":"Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75564","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80174","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41510","name":"Tongue to lip surgery","description":"Suture of tongue to lip for micrognathia (douglas type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38232","name":"Bone marrow harvest autolog","description":"Bone marrow harvesting for transplantation; autologous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43201","name":"Esoph scope w/submucous inj","description":"Esophagoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83497","name":"Assay of 5-hiaa","description":"Hydroxyindolacetic acid, 5-(hiaa)","date_of_service":"2026-06-05","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":"67400","name":"Explore/biopsy eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7510","name":"Prosthetic device repair rep","description":"Repair of prosthetic device, repair or replace minor parts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-06-05","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":"75954","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-06-05","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":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4770","name":"Blood collection tube/vacuum","description":"Blood collection tube, vacuum, for dialysis, per 50","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-06-05","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":"44227","name":"Lap close enterostomy","description":"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29847","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; internal fixation for fracture or instability","date_of_service":"2026-06-05","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":"30905","name":"Control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"53250","name":"Removal of urethra gland","description":"Excision of bulbourethral gland (cowpers gland)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86665","name":"Epstein-barr capsid vca","description":"Antibody; epstein-barr (eb) virus, viral capsid (vca)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-05","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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-05","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":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62360","name":"Insert spine infusion device","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86663","name":"Epstein-barr antibody","description":"Antibody; epstein-barr (eb) virus, early antigen (ea)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-05","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":"42100","name":"Biopsy roof of mouth","description":"Biopsy of palate, uvula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"C1874","name":"Stent, coated/cov w/del sys","description":"Stent, coated/covered, with delivery system","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41251","name":"Repair tongue laceration","description":"Repair of laceration 2.5 cm or less; posterior one-third of tongue","date_of_service":"2026-06-05","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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-05","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":"33533","name":"Cabg arterial single","description":"Coronary artery bypass, using arterial graft(s); single arterial graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-06-05","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":"57556","name":"Remove cervix repair bowel","description":"Excision of cervical stump, vaginal approach; with repair of enterocele","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-06-05","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":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-06-05","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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-06-05","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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36600","name":"Withdrawal of arterial blood","description":"Arterial puncture, withdrawal of blood for diagnosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"96119","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-05","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":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"39502","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64413","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33403","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"21632","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-06-05","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":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92130","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"37229","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"90470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-06-05","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":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-06-05","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":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57000","name":"Colpotomy w/exploration","description":"Colpotomy; with exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-06-05","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":"33476","name":"Revision of heart chamber","description":"Right ventricular resection for infundibular stenosis, with or without commissurotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67880","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-06-05","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":"83840","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32505","name":"Wedge resect of lung initial","description":"Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"67700","name":"Blepharotomy drg absc eyelid","description":"Blepharotomy, drainage of abscess, eyelid","date_of_service":"2026-06-05","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"99218","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21422","name":"Optx palatal/max fracture","description":"Open treatment of palatal or maxillary fracture (lefort i type);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47720","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; direct","date_of_service":"2026-06-05","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":"66680","name":"Repair iris & ciliary body","description":"Repair of iris, ciliary body (as for iridodialysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0515","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"26910","name":"Amputate metacarpal bone","description":"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84156","name":"Assay of protein urine","description":"Protein, total, except by refractometry; urine","date_of_service":"2026-06-05","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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26591","name":"Repair muscles of hand","description":"Repair, intrinsic muscles of hand, each muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27111","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to femoral neck","date_of_service":"2026-06-05","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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-06-05","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":"77520","name":"Proton trmt simple w/o comp","description":"Proton treatment delivery; simple, without compensation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58600","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-06-05","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":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32124","name":"Explore chest free adhesions","description":"Thoracotomy; with open intrapleural pneumonolysis","date_of_service":"2026-06-05","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":"54401","name":"Insert self-contd prosthesis","description":"Insertion of penile prosthesis; inflatable (self-contained)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"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":"32609","name":"Thoracoscopy w/bx pleura","description":"Thoracoscopy; with biopsy(ies) of pleura","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-06-05","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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27590","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level;","date_of_service":"2026-06-05","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":"82143","name":"Amniotic fluid scan","description":"Amniotic fluid scan (spectrophotometric)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1768","name":"Graft, vascular","description":"Graft, vascular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21076","name":"Impres&prep surg obt prosth","description":"Impression and custom preparation; surgical obturator prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29000","name":"Appl halo type body cast","description":"Application of halo type body cast (see 20661-20663 for insertion)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82810","name":"Blood gases o2 sat only","description":"Gases, blood, o2 saturation only, by direct measurement, except pulse oximetry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49323","name":"Laparo drain lymphocele","description":"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity","date_of_service":"2026-06-05","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":"99327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"D1206","name":"Topical fluoride varnish","description":"Topical fluoride varnish; therapeutic application for moderate to high caries risk patients","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44143","name":"Partial removal of colon","description":"Colectomy, partial; with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-06-05","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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-06-05","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":"61686","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, complex","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9503","name":"Tc99m medronate","description":"Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-06-05","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":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-05","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":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21082","name":"Impres&prep paltl aug prosth","description":"Impression and custom preparation; palatal augmentation prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24900","name":"Amputation of upper arm","description":"Amputation, arm through humerus; with primary closure","date_of_service":"2026-06-05","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":"26992","name":"Drainage of bone lesion","description":"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4224","name":"Parenteral administration ki","description":"Parenteral nutrition administration kit, per day","date_of_service":"2026-06-05","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":"42405","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; incisional","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","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":"93651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36005","name":"Injection ext venography","description":"Injection procedure for extremity venography (including introduction of needle or intracatheter)","date_of_service":"2026-06-05","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":"31592","name":"Cricotracheal resection","description":"Cricotracheal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-05","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":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-05","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"45339","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-06-05","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":"29871","name":"Arthrs knee surg for infctj","description":"Arthroscopy, knee, surgical; for infection, lavage and drainage","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92977","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"82553","name":"Creatine mb fraction","description":"Creatine kinase (ck), (cpk); mb fraction only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86771","name":"Shigella antibody","description":"Antibody; shigella","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"36481","name":"Insertion of catheter vein","description":"Percutaneous portal vein catheterization by any method","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-05","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":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86256","name":"Fluorescent antibody titer","description":"Fluorescent noninfectious agent antibody; titer, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-06-05","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":"35311","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision","date_of_service":"2026-06-05","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":"33220","name":"Repair lead pace-defib dual","description":"Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","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":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-06-05","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"21725","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; with cast application","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-05","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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-06-05","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":"15841","name":"Nerve palsy muscle graft","description":"Graft for facial nerve paralysis; free muscle graft (including obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-05","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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85335","name":"Factor inhibitor test","description":"Factor inhibitor test","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-05","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":"20225","name":"Bone biopsy trocar/ndl deep","description":"Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0019T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92518","name":"Vemp test i&r ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; ocular (ovemp)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"48511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82938","name":"Gastrin test","description":"Gastrin after secretin stimulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31290","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44205","name":"Lap colectomy part w/ileum","description":"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63190","name":"Incise spine nrv >2 segmnts","description":"Laminectomy with rhizotomy; more than 2 segments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-06-05","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":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"89130","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19304","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92353","name":"Fit aphakia spectcl multifoc","description":"Fitting of spectacle prosthesis for aphakia; multifocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0330T","name":"Tear film img uni/bi w/i&r","description":"Tear film imaging, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35495","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-06-05","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":"64761","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"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":"47510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-06-05","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":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-06-05","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":"26433","name":"Repair finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"69421","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33512","name":"Cabg vein three","description":"Coronary artery bypass, vein only; 3 coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"46751","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; child","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35476","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77370","name":"Radiation physics consult","description":"Special medical radiation physics consultation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23140","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","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":"21451","name":"Cltx mndblr fx w/mnpj","description":"Closed treatment of mandibular fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33860","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93503","name":"Insert/place heart catheter","description":"Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29730","name":"Windowing of cast","description":"Windowing of cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67805","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, different lids","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"95060","name":"Oph mucous membrane tests","description":"Ophthalmic mucous membrane tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27151","name":"Incision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4215","name":"Sterile needle","description":"Needle, sterile, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"35645","name":"Bpg subclavian-vertebral","description":"Bypass graft, with other than vein; subclavian-vertebral","date_of_service":"2026-06-05","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":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23350","name":"Injection for shoulder x-ray","description":"Injection procedure for shoulder arthrography or enhanced ct/mri shoulder arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37233","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-05","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":"27446","name":"Revision of knee joint","description":"Arthroplasty, knee, condyle and plateau; medial or lateral compartment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19330","name":"Rmvl ruptured breast implant","description":"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"94662","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-05","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":"55550","name":"Laparo ligate spermatic vein","description":"Laparoscopy, surgical, with ligation of spermatic veins for varicocele","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4480","name":"Vabra aspirator","description":"Vabra aspirator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"CPT","billing_code_type_version":"2026","billing_code":"G0324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-06-05","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37765","name":"Stab phleb veins xtr 10-20","description":"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-06-05","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":"35493","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27510","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86510","name":"Histoplasmosis skin test","description":"Skin test; histoplasmosis","date_of_service":"2026-06-05","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":"85390","name":"Fibrinolysins screen i&r","description":"Fibrinolysins or coagulopathy screen, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49570","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4918","name":"Venous pressure clamp","description":"Venous pressure clamp, for hemodialysis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S0191","name":"Misoprostol, oral, 200 mcg","description":"Misoprostol, oral, 200 mcg","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15789","name":"Chemical peel facial dermal","description":"Chemical peel, facial; dermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-06-05","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":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-06-05","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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-06-05","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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87299","name":"Antibody detection nos if","description":"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G6023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88285","name":"Chromosome count additional","description":"Chromosome analysis; additional cells counted, each study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-06-05","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":"61538","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"M0245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38100","name":"Removal of spleen total","description":"Splenectomy; total (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"L3215","name":"Orthopedic ftwear ladies oxf","description":"Orthopedic footwear, ladies shoe, oxford, each","date_of_service":"2026-06-05","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":"59870","name":"Evacuate mole of uterus","description":"Uterine evacuation and curettage for hydatidiform mole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77522","name":"Proton trmt simple w/comp","description":"Proton treatment delivery; simple, with compensation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"57105","name":"Biopsy vaginal mucosa xtnsv","description":"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-06-05","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":"36468","name":"Njx sclrsnt spider veins","description":"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk","date_of_service":"2026-06-05","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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-06-05","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":"41520","name":"Reconstruction tongue fold","description":"Frenoplasty (surgical revision of frenum, eg, with z-plasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-06-05","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":"83060","name":"Hgb sulfhemoglobin quan","description":"Hemoglobin; sulfhemoglobin, quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"66130","name":"Remove eye lesion","description":"Excision of lesion, sclera","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"47630","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21235","name":"Ear cartilage graft","description":"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-06-05","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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"36514","name":"Apheresis plasma","description":"Therapeutic apheresis; for plasma pheresis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-06-05","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":"45112","name":"Removal of rectum","description":"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-06-05","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":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-06-05","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","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":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-06-05","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":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"A7042","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-05","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":"99201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"21150","name":"Rcnstj mdfc lefrtii ant ntru","description":"Reconstruction midface, lefort ii; anterior intrusion (eg, treacher-collins syndrome)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45500","name":"Repair of rectum","description":"Proctoplasty; for stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"57135","name":"Excision vaginal cyst/tumor","description":"Excision of vaginal cyst or tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49084","name":"Peritoneal lavage","description":"Peritoneal lavage, including imaging guidance, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-06-05","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":"49505","name":"Prp i/hern init reduc >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3253","name":"Shoe molded plastazote cust","description":"Foot, molded shoe plastazote (or similar) custom fitted, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57311","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula; with bulbocavernosus transplant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"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":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"92120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33606","name":"Anastomosis/artery-aorta","description":"Anastomosis of pulmonary artery to aorta (damus-kaye-stansel procedure)","date_of_service":"2026-06-05","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":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57287","name":"Revise/remove sling repair","description":"Removal or revision of sling for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8427","name":"Ready gradient glove","description":"Gradient pressure aid (glove), ready made","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"38564","name":"Removal abdomen lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-05","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83788","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"33694","name":"Cmp rpr tof wo plm atrs ptch","description":"Complete repair tetralogy of fallot without pulmonary atresia; with transannular patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"P7001","name":"Culture bacterial urine","description":"Culture, bacterial, urine; quantitative, sensitivity study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15933","name":"Exc sac pr ulc prim str ostc","description":"Excision, sacral pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86060","name":"Antistreptolysin o titer","description":"Antistreptolysin 0; titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-05","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":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0146T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75961","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-05","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":"83060","name":"Hgb sulfhemoglobin quan","description":"Hemoglobin; sulfhemoglobin, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4247","name":"Betadine/iodine swabs/wipes","description":"Betadine or iodine swabs/wipes, per box","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80502","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"68320","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-05","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":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01632","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46210","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-06-05","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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-06-05","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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"23406","name":"Incise tendon(s) & muscle(s)","description":"Tenotomy, shoulder area; multiple tendons through same incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-06-05","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":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"66635","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; optical (separate procedure)","date_of_service":"2026-06-05","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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-05","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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"93237","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-06-05","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":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32035","name":"Thoracostomy w/rib resection","description":"Thoracostomy; with rib resection for empyema","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92516","name":"Facial nerve function test","description":"Facial nerve function studies (eg, electroneuronography)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"63706","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; larger than 5 cm diameter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-05","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":"26742","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-05","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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-06-05","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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-06-05","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":"27200","name":"Treat tail bone fracture","description":"Closed treatment of coccygeal fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84030","name":"Assay of blood pku","description":"Phenylalanine (pku), blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64642","name":"Chemodenerv 1 extremity 1-4","description":"Chemodenervation of one extremity; 1-4 muscle(s)","date_of_service":"2026-06-05","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":"38531","name":"Open bx/exc inguinofem nodes","description":"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67900","name":"Repair brow defect","description":"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29806","name":"Sho arthrs srg capsulorraphy","description":"Arthroscopy, shoulder, surgical; capsulorrhaphy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26715","name":"Treat knuckle dislocation","description":"Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"99220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-06-05","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":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"33401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"61850","name":"Implant neuroelectrodes","description":"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"19103","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21198","name":"Reconstr lwr jaw segment","description":"Osteotomy, mandible, segmental;","date_of_service":"2026-06-05","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":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24105","name":"Excision olecranon bursa","description":"Excision, olecranon bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86156","name":"Cold agglutinin screen","description":"Cold agglutinin; screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-05","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":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-06-05","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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2066","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0457","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33647","name":"Repair heart septum defects","description":"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-05","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":"E0241","name":"Bath tub wall rail","description":"Bath tub wall rail, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-06-05","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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61526","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21610","name":"Costotransversectomy","description":"Costotransversectomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-05","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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","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":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-06-05","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-06-05","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":"63194","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-05","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":"36469","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-06-05","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":"80150","name":"Assay of amikacin","description":"Amikacin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65860","name":"Severing ads ant sgm laser","description":"Severing adhesions of anterior segment, laser technique (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93544","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"18583","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33710","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93527","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49905","name":"Omental flap intra-abdom","description":"Omental flap, intra-abdominal (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64626","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-06-05","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":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81121","name":"Idh2 common variants","description":"Idh2 (isocitrate dehydrogenase 2 [nadp+], mitochondrial) (eg, glioma), common variants (eg, r140w, r172m)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-06-05","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":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57415","name":"Remove vaginal foreign body","description":"Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)","date_of_service":"2026-06-05","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":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63200","name":"Release spinal cord lumbar","description":"Laminectomy, with release of tethered spinal cord, lumbar","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-06-05","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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35476","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"11101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","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":"27372","name":"Removal of foreign body","description":"Removal of foreign body, deep, thigh region or knee area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-05","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49215","name":"Excise sacral spine tumor","description":"Excision of presacral or sacrococcygeal tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35535","name":"Art byp grft hepatorenal","description":"Bypass graft, with vein; hepatorenal","date_of_service":"2026-06-05","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":"92630","name":"Aud rehab pre-ling hear loss","description":"Auditory rehabilitation; prelingual hearing loss","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82331","name":"Calcium infusion test","description":"Calcium; after calcium infusion test","date_of_service":"2026-06-05","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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27441","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-06-05","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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G6020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43239","name":"Egd biopsy single/multiple","description":"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86885","name":"Coombs test indirect qual","description":"Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53020","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); except infant","date_of_service":"2026-06-05","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":"60271","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","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":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-06-05","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":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-06-05","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":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","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":"29590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28225","name":"Release of foot tendon","description":"Tenolysis, extensor, foot; single tendon","date_of_service":"2026-06-05","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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90808","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26820","name":"Thumb fusion with graft","description":"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-05","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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-05","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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-06-05","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":"55650","name":"Remove sperm duct pouch","description":"Vesiculectomy, any approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15734","name":"Muscle-skin graft trunk","description":"Muscle, myocutaneous, or fasciocutaneous flap; trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95075","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99442","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"29828","name":"Sho arthrs srg bicp tenodsis","description":"Arthroscopy, shoulder, surgical; biceps tenodesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20660","name":"Apply rem fixation device","description":"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-06-05","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-06-05","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":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"78584","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"81289","name":"Fxn gene known famil variant","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; known familial variant(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-06-05","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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","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":"29877","name":"Arthrs knee surg dbrdmt/shvg","description":"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)","date_of_service":"2026-06-05","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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75685","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-05","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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67314","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"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":"2026-06-05","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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"62319","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-05","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":"84080","name":"Assay alkaline phosphatases","description":"Phosphatase, alkaline; isoenzymes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32160","name":"Open chest heart massage","description":"Thoracotomy; with cardiac massage","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0502","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-06-05","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":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"29583","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83874","name":"Assay of myoglobin","description":"Myoglobin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84410","name":"Testosterone bioavailable","description":"Testosterone; bioavailable, direct measurement (eg, differential precipitation)","date_of_service":"2026-06-05","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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-06-05","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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"31805","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; intrathoracic","date_of_service":"2026-06-05","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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-06-05","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":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1753","name":"Cath, intravas ultrasound","description":"Catheter, intravascular ultrasound","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26675","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-06-05","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":"43881","name":"Impl/rplcmt gstr nstim eltrd","description":"Implantation or replacement of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-06-05","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":"47382","name":"Percut ablate liver rf","description":"Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27536","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93652","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-05","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-06-05","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":"31595","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23221","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-05","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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-05","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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"B4100","name":"Food thickener oral","description":"Food thickener, administered orally, per ounce","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-06-05","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":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-06-05","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":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-06-05","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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28005","name":"Treat foot bone lesion","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8427","name":"Ready gradient glove","description":"Gradient pressure aid (glove), ready made","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83907","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-06-05","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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L7272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"52270","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49906","name":"Free omental flap microvasc","description":"Free omental flap with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"36513","name":"Apheresis platelets","description":"Therapeutic apheresis; for platelets","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"27086","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; subcutaneous tissue","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27446","name":"Revision of knee joint","description":"Arthroplasty, knee, condyle and plateau; medial or lateral compartment","date_of_service":"2026-06-05","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":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"68130","name":"Exc les conjunctiva adj scl","description":"Excision of lesion, conjunctiva; with adjacent sclera","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61334","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90826","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.0,"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":"15850","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-05","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68761","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by plug, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42140","name":"Excision of uvula","description":"Uvulectomy, excision of uvula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"13150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27760","name":"Cltx medial ankle fx","description":"Closed treatment of medial malleolus fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23195","name":"Resection humeral head","description":"Resection, humeral head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35458","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"96150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-06-05","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":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93555","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"61470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-05","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":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58674","name":"Laps abltj uterine fibroids","description":"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31770","name":"Repair/graft of bronchus","description":"Bronchoplasty; graft repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"61500","name":"Crnec exc tum/bone les skull","description":"Craniectomy; with excision of tumor or other bone lesion of skull","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G2023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28470","name":"Cltx metatarsal fx wo mnp ea","description":"Closed treatment of metatarsal fracture; without manipulation, each","date_of_service":"2026-06-05","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":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-06-05","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":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8460","name":"Camisole post-mast","description":"Camisole, post-mastectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69405","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31800","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25441","name":"Arthrp w/prostc dstl rds","description":"Arthroplasty with prosthetic replacement; distal radius","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-06-05","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":"41116","name":"Excision of mouth lesion","description":"Excision, lesion of floor of mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28260","name":"Release of midfoot joint","description":"Capsulotomy, midfoot; medial release only (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-05","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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-05","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64836","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; ulnar motor","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58293","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-06-05","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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50234","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through same incision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50715","name":"Release of ureter","description":"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82108","name":"Assay of aluminum","description":"Aluminum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","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":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35361","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-05","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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84591","name":"Assay of nos vitamin","description":"Vitamin, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L7274","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-05","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":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64821","name":"Sympathectomy radial artery","description":"Sympathectomy; radial artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-06-05","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":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-05","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28060","name":"Partial removal foot fascia","description":"Fasciectomy, plantar fascia; partial (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0549T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"49652","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-06-05","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":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49082","name":"Abd paracentesis","description":"Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31600","name":"Planned tracheostomy","description":"Tracheostomy, planned (separate procedure);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90801","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21422","name":"Optx palatal/max fracture","description":"Open treatment of palatal or maxillary fracture (lefort i type);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84252","name":"Assay of vitamin b-2","description":"Riboflavin (vitamin b-2)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45111","name":"Partial removal of rectum","description":"Proctectomy; partial resection of rectum, transabdominal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-06-05","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":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"87481","name":"Candida dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, amplified probe technique","date_of_service":"2026-06-05","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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"66170","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43030","name":"Cricopharyngeal myotomy","description":"Cricopharyngeal myotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24420","name":"Osteoplasty humerus","description":"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)","date_of_service":"2026-06-05","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":"64566","name":"Neuroeltrd stim post tibial","description":"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35761","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26700","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-05","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":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"19303","name":"Mast simple complete","description":"Mastectomy, simple, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35631","name":"Bpg aor-celiac-msn-renal","description":"Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67346","name":"Biopsy eye muscle","description":"Biopsy of extraocular muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86255","name":"Fluorescent antibody screen","description":"Fluorescent noninfectious agent antibody; screen, each antibody","date_of_service":"2026-06-05","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":"93299","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27440","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"11721","name":"Debride nail 6 or more","description":"Debridement of nail(s) by any method(s); 6 or more","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"53235","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); male","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"54860","name":"Removal of epididymis","description":"Epididymectomy; unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-06-05","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":"86340","name":"Intrinsic factor antibody","description":"Intrinsic factor antibodies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86631","name":"Chlamydia antibody","description":"Antibody; chlamydia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33602","name":"Closure of valve","description":"Closure of semilunar valve (aortic or pulmonary) by suture or patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27562","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; requiring anesthesia","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78584","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","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":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"96150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"40801","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-06-05","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":"32500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83909","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S3818","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"19300","name":"Mastectomy for gynecomastia","description":"Mastectomy for gynecomastia","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64472","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54640","name":"Orchiopexy ingun/scrot appr","description":"Orchiopexy, inguinal or scrotal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86353","name":"Lymphocyte transformation","description":"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis","date_of_service":"2026-06-05","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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-06-05","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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"62000","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; simple, extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"Q4099","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-06-05","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":"55060","name":"Repair of hydrocele","description":"Repair of tunica vaginalis hydrocele (bottle type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21082","name":"Impres&prep paltl aug prosth","description":"Impression and custom preparation; palatal augmentation prosthesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-06-05","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":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-06-05","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":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87910","name":"Nfct agt gntyp alys cmv","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); cytomegalovirus","date_of_service":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"L3700","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"42821","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; age 12 or over","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41805","name":"Removal foreign body gum","description":"Removal of embedded foreign body from dentoalveolar structures; soft tissues","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-05","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":"31620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"20100","name":"Expl pentrg wound neck","description":"Exploration of penetrating wound (separate procedure); neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92950","name":"Heart/lung resuscitation cpr","description":"Cardiopulmonary resuscitation (eg, in cardiac arrest)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83905","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24420","name":"Osteoplasty humerus","description":"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27230","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83866","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15821","name":"Blepharp lwr eyelid fat pad","description":"Blepharoplasty, lower eyelid; with extensive herniated fat pad","date_of_service":"2026-06-05","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":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25425","name":"Repair/graft radius or ulna","description":"Repair of defect with autograft; radius or ulna","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82705","name":"Fats/lipids feces qual","description":"Fat or lipids, feces; qualitative","date_of_service":"2026-06-05","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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"46940","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-05","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":"93233","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28250","name":"Revision of foot fascia","description":"Division of plantar fascia and muscle (eg, steindler stripping) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0330T","name":"Tear film img uni/bi w/i&r","description":"Tear film imaging, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15835","name":"Exc excessive skin buttock","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock","date_of_service":"2026-06-05","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":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0241U","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55706","name":"Bx prst8 ndl sat sampling","description":"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50120","name":"Pyelotomy w/exploration","description":"Pyelotomy; with exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"99339","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21343","name":"Open tx dprsd front sinus fx","description":"Open treatment of depressed frontal sinus fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G6012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66150","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trephination with iridectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89105","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-05","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":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-06-05","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98942","name":"Chiropractic manj 5 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 5 regions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-05","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":"57110","name":"Vagnc compl rmvl vag wall","description":"Vaginectomy, complete removal of vaginal wall;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"38120","name":"Laparoscopy splenectomy","description":"Laparoscopy, surgical, splenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-05","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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69602","name":"Rev mstdc rslt mod rad mstdc","description":"Revision mastoidectomy; resulting in modified radical mastoidectomy","date_of_service":"2026-06-05","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":"95010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33647","name":"Repair heart septum defects","description":"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure","date_of_service":"2026-06-05","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":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-06-05","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":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82930","name":"Gastric analy w/ph ea spec","description":"Gastric acid analysis, includes ph if performed, each specimen","date_of_service":"2026-06-05","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":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0431","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43269","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"43239","name":"Egd biopsy single/multiple","description":"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"64508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52305","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple","date_of_service":"2026-06-05","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":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"50065","name":"Nl sec surg operj calculus","description":"Nephrolithotomy; secondary surgical operation for calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86280","name":"Hemagglutination inhibition","description":"Hemagglutination inhibition test (hai)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"90870","name":"Electroconvulsive therapy","description":"Electroconvulsive therapy (includes necessary monitoring)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47100","name":"Wedge biopsy of liver","description":"Biopsy of liver, wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9505","name":"Tl201 thallium","description":"Thallium tl-201 thallous chloride, diagnostic, per millicurie","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19367","name":"Brst rcnstj 1 pdcl tram flap","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42408","name":"Excision of salivary cyst","description":"Excision of sublingual salivary cyst (ranula)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-06-05","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"69840","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","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":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"A4247","name":"Betadine/iodine swabs/wipes","description":"Betadine or iodine swabs/wipes, per box","date_of_service":"2026-06-05","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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-05","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":"55815","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-05","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":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"40805","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4458","name":"Reusable enema bag","description":"Enema bag with tubing, reusable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35638","name":"Bpg aortobi-iliac","description":"Bypass graft, with other than vein; aortobi-iliac","date_of_service":"2026-06-05","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":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58260","name":"Vaginal hysterectomy","description":"Vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44960","name":"Appendectomy","description":"Appendectomy; for ruptured appendix with abscess or generalized peritonitis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94240","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"P9615","name":"Urine specimen collect mult","description":"Catheterization for collection of specimen(s) (multiple patients)","date_of_service":"2026-06-05","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":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-06-05","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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","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":"44620","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"96521","name":"Refill/maint portable pump","description":"Refilling and maintenance of portable pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-05","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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-05","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":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4652","name":"Microcapillary tube sealant","description":"Microcapillary tube sealant","date_of_service":"2026-06-05","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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-05","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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-06-05","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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"62310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"63250","name":"Revise spinal cord vsls crvl","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86651","name":"Encephalitis californ antbdy","description":"Antibody; encephalitis, california (la crosse)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-05","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":"94642","name":"Aerosol inhalation treatment","description":"Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-05","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":"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":"2026-06-05","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","","KC"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0146T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-06-05","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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99148","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-06-05","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":"33786","name":"Repair arterial trunk","description":"Total repair, truncus arteriosus (rastelli type operation)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43269","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27702","name":"Reconstruct ankle joint","description":"Arthroplasty, ankle; with implant (total ankle)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31081","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)","date_of_service":"2026-06-05","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":"75994","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28140","name":"Removal of metatarsal","description":"Metatarsectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64857","name":"Repair arm/leg nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition","date_of_service":"2026-06-05","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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28605","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-05","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":"66220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-06-05","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":"65426","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; with graft","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"87622","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-06-05","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":"G0392","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0309","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19103","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75558","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"40510","name":"Partial excision of lip","description":"Excision of lip; transverse wedge excision with primary closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4209","name":"5+ cc sterile syringe&needle","description":"Syringe with needle, sterile 5 cc or greater, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11740","name":"Evacuation subungual hmtma","description":"Evacuation of subungual hematoma","date_of_service":"2026-06-05","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":"52647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69705","name":"Nps surg dilat eust tube uni","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47371","name":"Laparo ablate liver cryosurg","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-06-05","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":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92586","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69670","name":"Remove mastoid air cells","description":"Mastoid obliteration (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","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":"88741","name":"Transcutaneous methb","description":"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","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":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27176","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57282","name":"Colpopexy extraperitoneal","description":"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)","date_of_service":"2026-06-05","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":"P9040","name":"Rbc leukoreduced irradiated","description":"Red blood cells, leukocytes reduced, irradiated, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"20922","name":"Removal of fascia for graft","description":"Fascia lata graft; by incision and area exposure, complex or sheet","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78586","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-06-05","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":"63740","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0503","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32650","name":"Thoracoscopy w/pleurodesis","description":"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)","date_of_service":"2026-06-05","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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23405","name":"Incision of tendon & muscle","description":"Tenotomy, shoulder area; single tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"23410","name":"Repair rotator cuff acute","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63746","name":"Removal of spinal shunt","description":"Removal of entire lumbosubarachnoid shunt system without replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-06-05","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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35491","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86816","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, single antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-06-05","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":"83722","name":"Lipoprtn dir meas sd ldl chl","description":"Lipoprotein, direct measurement; small dense ldl cholesterol","date_of_service":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"15400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","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":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-05","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":"78478","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"15953","name":"Exc trchntr pr ulc flp ostc","description":"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-05","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":"0467T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","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":"25360","name":"Revision of ulna","description":"Osteotomy; ulna","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89125","name":"Specimen fat stain","description":"Fat stain, feces, urine, or respiratory secretions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27818","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35303","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; popliteal artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-05","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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-05","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":"45910","name":"Dilation of rectal narrowing","description":"Dilation of rectal stricture (separate procedure) under anesthesia other than local","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25442","name":"Arthrp w/prostc dstl ulna","description":"Arthroplasty with prosthetic replacement; distal ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0144T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"69554","name":"Exc aurl glomus tum extended","description":"Excision aural glomus tumor; extended (extratemporal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-06-05","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":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-06-05","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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49582","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"85421","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42953","name":"Repair throat esophagus","description":"Pharyngoesophageal repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-06-05","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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90828","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37200","name":"Transcatheter biopsy","description":"Transcatheter biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-05","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":"0440T","name":"Abltj perc uxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-05","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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-05","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":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-05","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":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23125","name":"Claviculectomy total","description":"Claviculectomy; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49572","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35665","name":"Bpg iliofemoral","description":"Bypass graft, with other than vein; iliofemoral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57020","name":"Colpocentesis sep px","description":"Colpocentesis (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33645","name":"Revision of heart veins","description":"Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage","date_of_service":"2026-06-05","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":"23075","name":"Exc shoulder les sc < 3 cm","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23020","name":"Capsular contracture release","description":"Capsular contracture release (eg, sever type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"60281","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus; recurrent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-06-05","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":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-06-05","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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"94350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"21050","name":"Removal of jaw joint","description":"Condylectomy, temporomandibular joint (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83905","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0149T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"31656","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"57287","name":"Revise/remove sling repair","description":"Removal or revision of sling for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46910","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-06-05","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":"82615","name":"Test for urine cystines","description":"Cystine and homocystine, urine, qualitative","date_of_service":"2026-06-05","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":"26607","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27550","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; without anesthesia","date_of_service":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"G6022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31525","name":"Dx laryngoscopy excl nb","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn","date_of_service":"2026-06-05","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":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-05","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":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26478","name":"Lengthening of hand tendon","description":"Lengthening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38232","name":"Bone marrow harvest autolog","description":"Bone marrow harvesting for transplantation; autologous","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-05","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":"92640","name":"Aud brainstem implt programg","description":"Diagnostic analysis with programming of auditory brainstem implant, per hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-06-05","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":"49203","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-06-05","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":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-06-05","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":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"54800","name":"Biopsy of epididymis","description":"Biopsy of epididymis, needle","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4248","name":"Chlorhexidine antisept","description":"Chlorhexidine containing antiseptic, 1 ml","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99335","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-05","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":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41821","name":"Excision of gum flap","description":"Operculectomy, excision pericoronal tissues","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29305","name":"Appl hip spica cast 1 leg","description":"Application of hip spica cast; 1 leg","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87300","name":"Ag detection polyval if","description":"Infectious agent antigen detection by immunofluorescent technique, polyvalent for multiple organisms, each polyvalent antiserum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53460","name":"Revision of urethra","description":"Urethromeatoplasty, with partial excision of distal urethral segment (richardson type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"55500","name":"Removal of hydrocele","description":"Excision of hydrocele of spermatic cord, unilateral (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90816","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21261","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3320","name":"Shoe lift elev heel/sole cor","description":"Lift, elevation, heel and sole, cork, per inch","date_of_service":"2026-06-05","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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46606","name":"Anoscopy and biopsy","description":"Anoscopy; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-06-05","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":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"C1879","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-06-05","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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0149T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-05","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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86813","name":"Hla typing a b or c","description":"Hla typing; a, b, or c, multiple antigens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"89235","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25905","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna; open, circular (guillotine)","date_of_service":"2026-06-05","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":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"55815","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-06-05","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":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28490","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-06-05","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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-05","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":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-06-05","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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28570","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24331","name":"Flexor-plasty elbw w/advmnt","description":"Flexor-plasty, elbow (eg, steindler type advancement); with extensor advancement","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-05","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":"62294","name":"Injection into spinal artery","description":"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45915","name":"Remove rectal obstruction","description":"Removal of fecal impaction or foreign body (separate procedure) under anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-06-05","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":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-05","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":"L0430","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26556","name":"Toe joint transfer","description":"Transfer, free toe joint, with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31660","name":"Bronch thermoplsty 1 lobe","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-05","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":"82666","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26040","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67900","name":"Repair brow defect","description":"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-06-05","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":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26553","name":"Single transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43256","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"34800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"G0447","name":"Behavior counsel obesity 15m","description":"Face-to-face behavioral counseling for obesity, 15 minutes","date_of_service":"2026-06-05","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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"43330","name":"Esophagomyotomy abdominal","description":"Esophagomyotomy (heller type); abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86340","name":"Intrinsic factor antibody","description":"Intrinsic factor antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-06-05","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","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":"82101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33460","name":"Revision of tricuspid valve","description":"Valvectomy, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-06-05","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":"0249T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6024","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43246","name":"Egd place gastrostomy tube","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92506","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-06-05","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":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-05","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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"P7001","name":"Culture bacterial urine","description":"Culture, bacterial, urine; quantitative, sensitivity study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"50280","name":"Exc/unroofing cyst kidney","description":"Excision or unroofing of cyst(s) of kidney","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86485","name":"Skin test candida","description":"Skin test; candida","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32652","name":"Thoracoscopy rem totl cortex","description":"Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis","date_of_service":"2026-06-05","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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27105","name":"Transfer of spinal muscle","description":"Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)","date_of_service":"2026-06-05","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":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-06-05","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":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-06-05","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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15301","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3206","name":"Hightop w/ supp/pronator chi","description":"Orthopedic shoe, hightop with supinator or pronator, child","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"H0001","name":"Alcohol and/or drug assess","description":"Alcohol and/or drug assessment","date_of_service":"2026-06-05","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"23802","name":"Arthrd glenohumeral jt w/grf","description":"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35483","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","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":"44025","name":"Incision of large bowel","description":"Colotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21601","name":"Exc chest wall tumor w/ribs","description":"Excision of chest wall tumor including rib(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"39561","name":"Resect diaphragm complex","description":"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"40840","name":"Reconstruction of mouth","description":"Vestibuloplasty; anterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-06-05","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-05","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"0249T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-05","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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25675","name":"Cltx dstl rad/uln dislc mnpj","description":"Closed treatment of distal radioulnar dislocation with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35551","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-06-05","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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","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":"63741","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-06-05","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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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":"89100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A9560","name":"Tc99m labeled rbc","description":"Technetium tc-99m labeled red blood cells, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"61460","name":"Crnec sopl sctj 1+crnl nrv","description":"Craniectomy, suboccipital; for section of 1 or more cranial nerves","date_of_service":"2026-06-05","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":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43458","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86808","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); quick method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23174","name":"Sqstrctmy humrl head srg nck","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck","date_of_service":"2026-06-05","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":"57505","name":"Endocervical curettage","description":"Endocervical curettage (not done as part of a dilation and curettage)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27479","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33960","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99356","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77422","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80196","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"61458","name":"Crnec sopl xpl/dcmpr crl nrv","description":"Craniectomy, suboccipital; for exploration or decompression of cranial nerves","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54522","name":"Orchiectomy partial","description":"Orchiectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23221","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4306","name":"Drug delivery system <=50 ml","description":"Disposable drug delivery system, flow rate of less than 50 ml per hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-06-05","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":"92226","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"30600","name":"Repair mouth/nose fistula","description":"Repair fistula; oronasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-05","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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33681","name":"Closure 1 vsd w/wo patch","description":"Closure of single ventricular septal defect, with or without patch;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-05","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":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43280","name":"Laparoscopy fundoplasty","description":"Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures)","date_of_service":"2026-06-05","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":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29867","name":"Allgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-06-05","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":"45321","name":"Proctosigmoidoscopy volvul","description":"Proctosigmoidoscopy, rigid; with decompression of volvulus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-05","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":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33503","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46270","name":"Remove anal fist subq","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous","date_of_service":"2026-06-05","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":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-06-05","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83893","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23410","name":"Repair rotator cuff acute","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32671","name":"Thoracoscopy pneumonectomy","description":"Thoracoscopy, surgical; with removal of lung (pneumonectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","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":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"63199","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-06-05","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-06-05","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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"53444","name":"Insert tandem cuff","description":"Insertion of tandem cuff (dual cuff)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-06-05","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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-05","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":"27385","name":"Repair of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96521","name":"Refill/maint portable pump","description":"Refilling and maintenance of portable pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75954","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"25391","name":"Lengthen radius or ulna","description":"Osteoplasty, radius or ulna; lengthening with autograft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"20694","name":"Rmvl ext fixj sys under anes","description":"Removal, under anesthesia, of external fixation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"44312","name":"Revision of ileostomy","description":"Revision of ileostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"60270","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-05","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-06-05","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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31230","name":"Removal of upper jaw","description":"Maxillectomy; with orbital exenteration (en bloc)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-06-05","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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75676","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-05","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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S3835","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-05","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"57022","name":"I&d vaginal hematoma ob/pp","description":"Incision and drainage of vaginal hematoma; obstetrical/postpartum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28320","name":"Repair of foot bones","description":"Repair, nonunion or malunion; tarsal bones","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-05","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":"61519","name":"Remove brain lining lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87274","name":"Herpes simplex 1 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 1","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"M0241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"99219","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57100","name":"Biopsy vaginal mucosa simple","description":"Biopsy of vaginal mucosa; simple (separate procedure)","date_of_service":"2026-06-05","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":"87477","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83909","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-05","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":"G6017","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85421","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay","date_of_service":"2026-06-05","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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35452","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35459","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41872","name":"Gingivoplasty each quadrant","description":"Gingivoplasty, each quadrant (specify)","date_of_service":"2026-06-05","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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31291","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93544","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"27443","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"65779","name":"Cover eye w/membrane suture","description":"Placement of amniotic membrane on the ocular surface; single layer, sutured","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45805","name":"Repair fistula w/colostomy","description":"Closure of rectovesical fistula; with colostomy","date_of_service":"2026-06-05","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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V5241","name":"Dispensing fee, monaural","description":"Dispensing fee, monaural hearing aid, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43236","name":"Uppr gi scope w/submuc inj","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-06-05","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":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-05","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":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-06-05","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":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"41825","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-06-05","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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67345","name":"Destroy nerve of eye muscle","description":"Chemodenervation of extraocular muscle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"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":"2026-06-05","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":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93702","name":"Bis xtracell fluid analysis","description":"Bioimpedance spectroscopy (bis), extracellular fluid analysis for lymphedema assessment(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-06-05","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64580","name":"Opn impltj nea neuromuscular","description":"Open implantation of neurostimulator electrode array; neuromuscular","date_of_service":"2026-06-05","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":"27530","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"11960","name":"Insert tissue expander(s)","description":"Insertion of tissue expander(s) for other than breast, including subsequent expansion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34825","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"34900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44205","name":"Lap colectomy part w/ileum","description":"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-06-05","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":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"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":"30124","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; simple, skin, subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-06-05","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":"31730","name":"Intro windpipe wire/tube","description":"Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3672","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-06-05","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":"45805","name":"Repair fistula w/colostomy","description":"Closure of rectovesical fistula; with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86386","name":"Nuclear matrix protein 22","description":"Nuclear matrix protein 22 (nmp22), qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86905","name":"Blood typing rbc antigens","description":"Blood typing, serologic; rbc antigens, other than abo or rh (d), each","date_of_service":"2026-06-05","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":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-05","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":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"96151","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87267","name":"Enterovirus antibody dfa","description":"Infectious agent antigen detection by immunofluorescent technique; enterovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-05","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":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0436","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35251","name":"Rpr blvsl vn grf intra-abdl","description":"Repair blood vessel with vein graft; intra-abdominal","date_of_service":"2026-06-05","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":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-06-05","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":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"89325","name":"Sperm antibody test","description":"Sperm antibodies","date_of_service":"2026-06-05","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":"75722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32670","name":"Thoracoscopy bilobectomy","description":"Thoracoscopy, surgical; with removal of two lobes (bilobectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-05","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":"32420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-05","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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35583","name":"Vein byp grft fem-popliteal","description":"In-situ vein bypass; femoral-popliteal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"92560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82777","name":"Galectin-3","description":"Galectin-3","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86732","name":"Mucormycosis antibody","description":"Antibody; mucormycosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57296","name":"Revise vag graft open abd","description":"Revision (including removal) of prosthetic vaginal graft; open abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0504","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-06-05","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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-06-05","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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39540","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-06-05","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","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":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"43100","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-05","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":"29220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"55840","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","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":"29582","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"G6013","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20912","name":"Remove cartilage for graft","description":"Cartilage graft; nasal septum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"A4220","name":"Infusion pump refill kit","description":"Refill kit for implantable infusion pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-06-05","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":"87269","name":"Giardia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; giardia","date_of_service":"2026-06-05","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":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53440","name":"Male sling procedure","description":"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86617","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunoblot)","date_of_service":"2026-06-05","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":"91105","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51580","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92987","name":"Revision of mitral valve","description":"Percutaneous balloon valvuloplasty; mitral valve","date_of_service":"2026-06-05","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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","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":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-06-05","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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54535","name":"Extensive testis surgery","description":"Orchiectomy, radical, for tumor; with abdominal exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-05","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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","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":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51700","name":"Irrigation of bladder","description":"Bladder irrigation, simple, lavage and/or instillation","date_of_service":"2026-06-05","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":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-06-05","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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-06-05","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":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"25332","name":"Revise wrist joint","description":"Arthroplasty, wrist, with or without interposition, with or without external or internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"41113","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; posterior one-third","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82286","name":"Assay of bradykinin","description":"Bradykinin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86360","name":"T cell absolute count/ratio","description":"T cells; absolute cd4 and cd8 count, including ratio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"25335","name":"Centralization wrist on ulna","description":"Centralization of wrist on ulna (eg, radial club hand)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69820","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-06-05","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-05","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":"34803","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52290","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82507","name":"Assay of citrate","description":"Citrate","date_of_service":"2026-06-05","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":"42508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"54860","name":"Removal of epididymis","description":"Epididymectomy; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84540","name":"Assay of urine/urea-n","description":"Urea nitrogen, urine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6261","name":"Wound filler gel/paste /oz","description":"Wound filler, gel/paste, per fluid ounce, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"25825","name":"Arthrd wrist with autograft","description":"Arthrodesis, wrist; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"30120","name":"Revision of nose","description":"Excision or surgical planing of skin of nose for rhinophyma","date_of_service":"2026-06-05","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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-06-05","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":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88154","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99325","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93514","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29905","name":"Subtalar arthro w/exc","description":"Arthroscopy, subtalar joint, surgical; with synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64632","name":"N block inj common digit","description":"Destruction by neurolytic agent; plantar common digital nerve","date_of_service":"2026-06-05","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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78267","name":"Urea breath tst c-14 acquisj","description":"Urea breath test, c-14 (isotopic); acquisition for analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27323","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; superficial","date_of_service":"2026-06-05","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"81286","name":"Fxn gene full gene sequence","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; full gene sequence","date_of_service":"2026-06-05","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":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-05","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":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77525","name":"Proton treatment complex","description":"Proton treatment delivery; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"96118","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45309","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"99149","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24344","name":"Reconstruct elbow lat ligmnt","description":"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"94720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48140","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"64681","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35612","name":"Bpg subclavian-subclavian","description":"Bypass graft, with other than vein; subclavian-subclavian","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64476","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28415","name":"Optx calcaneal fracture","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"43640","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"54408","name":"Repair multi-comp penis pros","description":"Repair of component(s) of a multi-component, inflatable penile prosthesis","date_of_service":"2026-06-05","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":"21335","name":"Open tx nose & septal fx","description":"Open treatment of nasal fracture; with concomitant open treatment of fractured septum","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15825","name":"Rhytdct nck pltysml tghtg","description":"Rhytidectomy; neck with platysmal tightening (platysmal flap, p-flap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65750","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in aphakia)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64766","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35482","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-06-05","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":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","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":"87527","name":"Hepatitis g dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","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":"35636","name":"Bpg splenorenal","description":"Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-06-05","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":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-06-05","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":"M0243","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-06-05","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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"G6024","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99354","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40652","name":"Rpr lip fth<half ver height","description":"Repair lip, full thickness; up to half vertical height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26676","name":"Pin hand dislocation","description":"Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87497","name":"Cytomeg dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, quantification","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-06-05","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":"36440","name":"Bld push tfuj 2 yr/<","description":"Push transfusion, blood, 2 years or younger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47505","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67345","name":"Destroy nerve of eye muscle","description":"Chemodenervation of extraocular muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55550","name":"Laparo ligate spermatic vein","description":"Laparoscopy, surgical, with ligation of spermatic veins for varicocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-05","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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91312","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","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":"81007","name":"Urine screen for bacteria","description":"Urinalysis; bacteriuria screen, except by culture or dipstick","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52290","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92987","name":"Revision of mitral valve","description":"Percutaneous balloon valvuloplasty; mitral valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"46288","name":"Repair anal fistula","description":"Closure of anal fistula with rectal advancement flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6571","name":"G com garment genital custm","description":"Gradient compression garment, genital region, custom, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","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":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87530","name":"Hsv dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-06-05","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":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-06-05","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":"51600","name":"Injection for bladder x-ray","description":"Injection procedure for cystography or voiding urethrocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49580","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"58356","name":"Endometrial cryoablation","description":"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15850","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80164","name":"Assay dipropylacetic acd tot","description":"Valproic acid (dipropylacetic acid); total","date_of_service":"2026-06-05","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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-05","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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-05","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":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36145","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-05","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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-06-05","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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32656","name":"Thoracoscopy w/pleurectomy","description":"Thoracoscopy, surgical; with parietal pleurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"47525","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0498T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","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":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15820","name":"Blepharoplasty lower eyelid","description":"Blepharoplasty, lower eyelid;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-06-05","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":"92354","name":"Fitg spect low vis 1system","description":"Fitting of spectacle mounted low vision aid; single element system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"69740","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion","date_of_service":"2026-06-05","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69970","name":"Remove inner ear lesion","description":"Removal of tumor, temporal bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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 e","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-05","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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-05","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":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"66825","name":"Reposition intraocular lens","description":"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)","date_of_service":"2026-06-05","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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-06-05","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":"31292","name":"Nsl/sins ndsc med/inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"56632","name":"Vlvctmy rad prtl bi lymphad","description":"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"58543","name":"Lsh uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38550","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35221","name":"Rpr bld vsl dir intra-abdl","description":"Repair blood vessel, direct; intra-abdominal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62365","name":"Remove spine infusion device","description":"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion","date_of_service":"2026-06-05","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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47740","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55520","name":"Removal of sperm cord lesion","description":"Excision of lesion of spermatic cord (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"53010","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85420","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32445","name":"Removal of lung extrapleural","description":"Removal of lung, pneumonectomy; extrapleural","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35481","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-06-05","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49041","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","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":"53620","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; initial","date_of_service":"2026-06-05","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":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86606","name":"Aspergillus antibody","description":"Antibody; aspergillus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"94610","name":"Intrapulm surfactant admn","description":"Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75660","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26593","name":"Release muscles of hand","description":"Release, intrinsic muscles of hand, each muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48547","name":"Duodenal exclusion","description":"Duodenal exclusion with gastrojejunostomy for pancreatic injury","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25394","name":"Repair carpal bone shorten","description":"Osteoplasty, carpal bone, shortening","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6215","name":"Foam dressing wound filler","description":"Foam dressing, wound filler, sterile, per gram","date_of_service":"2026-06-05","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":"L3254","name":"Orth foot non-stndard size/w","description":"Non-standard size or width","date_of_service":"2026-06-05","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":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9282","name":"Wig any type","description":"Wig, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"2026-06-05","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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21199","name":"Reconstr lwr jaw w/advance","description":"Osteotomy, mandible, segmental; with genioglossus advancement","date_of_service":"2026-06-05","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":"58950","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11982","name":"Remove drug implant device","description":"Removal, non-biodegradable drug delivery implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85613","name":"Russell viper venom diluted","description":"Russell viper venom time (includes venom); diluted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85390","name":"Fibrinolysins screen i&r","description":"Fibrinolysins or coagulopathy screen, interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-05","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":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27350","name":"Removal of kneecap","description":"Patellectomy or hemipatellectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"P9612","name":"Catheterize for urine spec","description":"Catheterization for collection of specimen, single patient, all places of service","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-06-05","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":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31590","name":"Reinnervate larynx","description":"Laryngeal reinnervation by neuromuscular pedicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55650","name":"Remove sperm duct pouch","description":"Vesiculectomy, any approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-05","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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31370","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); horizontal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29873","name":"Arthrs knee surg w/lat rls","description":"Arthroscopy, knee, surgical; with lateral release","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0398T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82492","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92517","name":"Vemp test i&r cervical","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37226","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25909","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"30150","name":"Rhinectomy partial","description":"Rhinectomy; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42830","name":"Removal of adenoids","description":"Adenoidectomy, primary; younger than age 12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3252","name":"Shoe molded plastazote cust","description":"Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23525","name":"Cltx strnclav dislc w/mnpj","description":"Closed treatment of sternoclavicular dislocation; with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"12021","name":"Tx supfc wnd dehsn w/packing","description":"Treatment of superficial wound dehiscence; with packing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0325","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58970","name":"Retrieval of oocyte","description":"Follicle puncture for oocyte retrieval, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26040","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); percutaneous","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88273","name":"Cytogenetics 10-30","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells (eg, for microdeletions)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-05","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":"31395","name":"Reconstruct larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; with reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33050","name":"Resect heart sac lesion","description":"Resection of pericardial cyst or tumor","date_of_service":"2026-06-05","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":"53260","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral polyp(s), distal urethra","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43262","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27696","name":"Repair of ankle ligaments","description":"Repair, primary, disrupted ligament, ankle; both collateral ligaments","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-05","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":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-05","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":"29897","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28086","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; flexor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"0241U","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43771","name":"Lap revise gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64713","name":"Revision of arm nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50592","name":"Perc rf ablate renal tumor","description":"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27658","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-05","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":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-05","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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-06-05","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":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27882","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; open, circular (guillotine)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33891","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"90870","name":"Electroconvulsive therapy","description":"Electroconvulsive therapy (includes necessary monitoring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-06-05","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":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-06-05","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":"68816","name":"Probe nl duct w/balloon","description":"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-06-05","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":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-06-05","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":"50715","name":"Release of ureter","description":"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-06-05","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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","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":"83925","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-06-05","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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-06-05","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":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67570","name":"Decompress optic nerve","description":"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)","date_of_service":"2026-06-05","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":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28280","name":"Fusion of toes","description":"Syndactylization, toes (eg, webbing or kelikian type procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-05","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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-05","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":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87197","name":"Serum bactericidal titer","description":"Serum bactericidal titer (schlichter test)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75954","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43640","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective","date_of_service":"2026-06-05","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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58750","name":"Repair oviduct","description":"Tubotubal anastomosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-05","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":"T4536","name":"Reusable pull-on any size","description":"Incontinence product, protective underwear/pull-on, reusable, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-06-05","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":"62010","name":"Treatment of head injury","description":"Elevation of depressed skull fracture; with repair of dura and/or debridement of brain","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50390","name":"Drainage of kidney lesion","description":"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82728","name":"Assay of ferritin","description":"Ferritin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-06-05","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":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","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":"47801","name":"Placement bile duct support","description":"Placement of choledochal stent","date_of_service":"2026-06-05","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":"63275","name":"Bx/exc xdrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","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":"0042T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","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":["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":"2026-06-05","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":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33503","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32220","name":"Release of lung","description":"Decortication, pulmonary (separate procedure); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21240","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80170","name":"Assay of gentamicin","description":"Gentamicin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"75685","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41105","name":"Biopsy of tongue","description":"Biopsy of tongue; posterior one-third","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-06-05","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":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92506","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G6019","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61609","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33285","name":"Insj subq car rhythm mntr","description":"Insertion, subcutaneous cardiac rhythm monitor, including programming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-06-05","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-06-05","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":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21260","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28011","name":"Incision of toe tendons","description":"Tenotomy, percutaneous, toe; multiple tendons","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"86891","name":"Autologous blood op salvage","description":"Autologous blood or component, collection processing and storage; intra- or postoperative salvage","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33788","name":"Revision of pulmonary artery","description":"Reimplantation of an anomalous pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0898","name":"Power wheelchair noc","description":"Power wheelchair, not otherwise classified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87652","name":"Strep a dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43205","name":"Esophagus endoscopy/ligation","description":"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86808","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); quick method","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69806","name":"Explore inner ear","description":"Endolymphatic sac operation; with shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84315","name":"Body fluid specific gravity","description":"Specific gravity (except urine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25251","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; complicated, including total wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27151","name":"Incision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36835","name":"Insertion thomas shunt","description":"Insertion of thomas shunt (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35471","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6025","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-06-05","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"43310","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-05","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":"B4083","name":"Enteral stomach tube levine","description":"Stomach tube - levine type","date_of_service":"2026-06-05","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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-05","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":"24155","name":"Resection of elbow joint","description":"Resection of elbow joint (arthrectomy)","date_of_service":"2026-06-05","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":"82541","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-06-05","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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42953","name":"Repair throat esophagus","description":"Pharyngoesophageal repair","date_of_service":"2026-06-05","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":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-06-05","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":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15792","name":"Chem peel nonfacial epidrm","description":"Chemical peel, nonfacial; epidermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-06-05","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":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-05","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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-06-05","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":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35626","name":"Bpg aor-subcla/innom/carotid","description":"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93524","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-05","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":"42140","name":"Excision of uvula","description":"Uvulectomy, excision of uvula","date_of_service":"2026-06-05","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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-06-05","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":"57720","name":"Revision of cervix","description":"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"33332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21462","name":"Optx mndblr fx w/ntrdntl","description":"Open treatment of mandibular fracture; with interdental fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"89132","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82607","name":"Vitamin b-12","description":"Cyanocobalamin (vitamin b-12);","date_of_service":"2026-06-05","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":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64413","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0275T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-06-05","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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-06-05","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":"21343","name":"Open tx dprsd front sinus fx","description":"Open treatment of depressed frontal sinus fracture","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"34806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4860","name":"Disposable catheter tips","description":"Disposable catheter tips for peritoneal dialysis, per 10","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"51900","name":"Repair bladder/vagina lesion","description":"Closure of vesicovaginal fistula, abdominal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43621","name":"Removal of stomach","description":"Gastrectomy, total; with roux-en-y reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93668","name":"Peripheral vascular rehab","description":"Peripheral arterial disease (pad) rehabilitation, per session","date_of_service":"2026-06-05","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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-05","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"54200","name":"Injection px peyronie ds","description":"Injection procedure for peyronie disease;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33510","name":"Cabg vein single","description":"Coronary artery bypass, vein only; single coronary venous graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82379","name":"Assay of carnitine","description":"Carnitine (total and free), quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"24900","name":"Amputation of upper arm","description":"Amputation, arm through humerus; with primary closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-06-05","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":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-06-05","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":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54600","name":"Reduce testis torsion","description":"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51080","name":"Drainage of bladder abscess","description":"Drainage of perivesical or prevesical space abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28515","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-06-05","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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28150","name":"Removal of toe","description":"Phalangectomy, toe, each toe","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92633","name":"Aud rehab postling hear loss","description":"Auditory rehabilitation; postlingual hearing loss","date_of_service":"2026-06-05","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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61315","name":"Crnec/crnot ittl ntracereblr","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-06-05","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":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93232","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-06-05","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":"24164","name":"Removal prosth radial head","description":"Removal of prosthesis, includes debridement and synovectomy when performed; radial head","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"S8999","name":"Resuscitation bag","description":"Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)","date_of_service":"2026-06-05","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":"89050","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86343","name":"Leukocyte histamine release","description":"Leukocyte histamine release test (lhr)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5008","name":"Hearing screening","description":"Hearing screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57555","name":"Remove cervix/repair vagina","description":"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0512","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87101","name":"Skin fungi culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49652","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"34802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42835","name":"Removal of adenoids","description":"Adenoidectomy, secondary; younger than age 12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","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":"31572","name":"Largsc w/laser dstrj les","description":"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-06-05","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":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-06-05","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":"0191T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82016","name":"Acylcarnitines qual","description":"Acylcarnitines; qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-06-05","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":"27635","name":"Remove lower leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"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"]}],"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"]}],"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"]}],"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"]}],"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"]}],"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"]}],"provider_references":[4]},{"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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-06-05","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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57135","name":"Excision vaginal cyst/tumor","description":"Excision of vaginal cyst or tumor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62116","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27111","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to femoral neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"16036","name":"Escharotomy ea addl incision","description":"Escharotomy; each additional incision (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"35694","name":"Art trnsposj subclav carotid","description":"Transposition and/or reimplantation; subclavian to carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66630","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88720","name":"Bilirubin total transcut","description":"Bilirubin, total, transcutaneous","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0456","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-06-05","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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-06-05","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":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-06-05","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":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71060","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"64840","name":"Repair of leg nerve","description":"Suture of posterior tibial nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-06-05","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":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L1500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-06-05","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":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-06-05","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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36820","name":"Av fusion/forearm vein","description":"Arteriovenous anastomosis, open; by forearm vein transposition","date_of_service":"2026-06-05","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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21337","name":"Closed tx septal&nose fx","description":"Closed treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-06-05","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":"66852","name":"Removal of lens material","description":"Removal of lens material; pars plana approach, with or without vitrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-05","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":"35221","name":"Rpr bld vsl dir intra-abdl","description":"Repair blood vessel, direct; intra-abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64804","name":"Sympathectomy cervicothorac","description":"Sympathectomy, cervicothoracic","date_of_service":"2026-06-05","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":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","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":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83825","name":"Assay of mercury","description":"Mercury, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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 decis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","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":"84035","name":"Assay of phenylketones","description":"Phenylketones, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86940","name":"Hemolysins/agglutinins auto","description":"Hemolysins and agglutinins; auto, screen, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36000","name":"Place needle in vein","description":"Introduction of needle or intracatheter, vein","date_of_service":"2026-06-05","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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-06-05","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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65130","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after evisceration, in scleral shell","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"33019","name":"Perq prcrd drg insj cath ct","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including ct guidance","date_of_service":"2026-06-05","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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"66985","name":"Insert lens prosthesis","description":"Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69511","name":"Extensive mastoid surgery","description":"Mastoidectomy; radical","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25259","name":"Manipulate wrist w/anesthes","description":"Manipulation, wrist, under anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32655","name":"Thoracoscopy resect bullae","description":"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-05","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":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0468T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"10021","name":"Fna bx w/o img gdn 1st les","description":"Fine needle aspiration biopsy, without imaging guidance; first lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35454","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-06-05","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":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83698","name":"Assay lipoprotein pla2","description":"Lipoprotein-associated phospholipase a2 (lp-pla2)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-06-05","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":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-06-05","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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83499","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92577","name":"Stenger test speech","description":"Stenger test, speech","date_of_service":"2026-06-05","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":"43290","name":"Egd flx trnsorl dplmnt balo","description":"Esophagogastroduodenoscopy, flexible, transoral; with deployment of intragastric bariatric balloon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"64647","name":"Chemodenerv trunk musc 6/>","description":"Chemodenervation of trunk muscle(s); 6 or more muscles","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"83020","name":"Hemoglobin electrophoresis","description":"Hemoglobin fractionation and quantitation; electrophoresis (eg, a2, s, c, and/or f)","date_of_service":"2026-06-05","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":"S2083","name":"Adjustment gastric band","description":"Adjustment of gastric band diameter via subcutaneous port by injection or aspiration of saline","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15758","name":"Free fascial flap microvasc","description":"Free fascial flap with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61567","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery","date_of_service":"2026-06-05","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":"30520","name":"Repair of nasal septum","description":"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36818","name":"Av fuse uppr arm cephalic","description":"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"20000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82544","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"65150","name":"Revise ocular implant","description":"Reinsertion of ocular implant; with or without conjunctival graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49081","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31660","name":"Bronch thermoplsty 1 lobe","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"49324","name":"Lap insert tunnel ip cath","description":"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25100","name":"Biopsy of wrist joint","description":"Arthrotomy, wrist joint; with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15336","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"66625","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)","date_of_service":"2026-06-05","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":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-06-05","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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77416","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45108","name":"Anorectal myomectomy","description":"Anorectal myomectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22524","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85347","name":"Coagulation time activated","description":"Coagulation time; activated","date_of_service":"2026-06-05","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":"33472","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-05","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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3652","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33212","name":"Insert pulse gen sngl lead","description":"Insertion of pacemaker pulse generator only; with existing single lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84704","name":"Hcg free betachain test","description":"Gonadotropin, chorionic (hcg); free beta chain","date_of_service":"2026-06-05","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":"36015","name":"Place catheter in artery","description":"Selective catheter placement, segmental or subsegmental pulmonary artery","date_of_service":"2026-06-05","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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-06-05","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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-06-05","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":"35241","name":"Rpr blvsl vn grf ntrthrc w/b","description":"Repair blood vessel with vein graft; intrathoracic, with bypass","date_of_service":"2026-06-05","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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-05","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":"15841","name":"Nerve palsy muscle graft","description":"Graft for facial nerve paralysis; free muscle graft (including obtaining graft)","date_of_service":"2026-06-05","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":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-05","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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-05","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":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","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":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-05","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2860","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"40814","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-06-05","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":"15851","name":"Removal sutr/staple req anes","description":"Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-06-05","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":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4510","name":"Full length surg stocking","description":"Surgical stockings full length, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28302","name":"Incision of ankle bone","description":"Osteotomy; talus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","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":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-06-05","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":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95012","name":"Nitric oxide exp gas deter","description":"Nitric oxide expired gas determination","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"90809","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51795","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"36140","name":"Intro ndl icath upr/lxtr art","description":"Introduction of needle or intracatheter, upper or lower extremity artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G9678","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95936","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-06-05","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":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"37785","name":"Ligate/divide/excise vein","description":"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37228","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54115","name":"Treatment of penis lesion","description":"Removal foreign body from deep penile tissue (eg, plastic implant)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57320","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-06-05","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":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-06-05","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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27510","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-06-05","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":"36600","name":"Withdrawal of arterial blood","description":"Arterial puncture, withdrawal of blood for diagnosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29893","name":"Endoscopic plantr fasciotomy","description":"Endoscopic plantar fasciotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50320","name":"Remove kidney living donor","description":"Donor nephrectomy (including cold preservation); open, from living donor","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0071A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"30220","name":"Insert nasal septal button","description":"Insertion, nasal septal prosthesis (button)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"99143","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43775","name":"Lap sleeve gastrectomy","description":"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82376","name":"Assay carboxyhb qual","description":"Carboxyhemoglobin; qualitative","date_of_service":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26100","name":"Biopsy hand joint lining","description":"Arthrotomy with biopsy; carpometacarpal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-06-05","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":"95978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37226","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57423","name":"Repair paravag defect lap","description":"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50398","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","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":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-06-05","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":"T4542","name":"Small disposable underpad","description":"Incontinence product, disposable underpad, small size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82487","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-06-05","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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35485","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21400","name":"Closed tx orbit w/o manipulj","description":"Closed treatment of fracture of orbit, except blowout; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83894","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32160","name":"Open chest heart massage","description":"Thoracotomy; with cardiac massage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-06-05","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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-06-05","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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-06-05","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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-05","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":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27695","name":"Repair of ankle ligament","description":"Repair, primary, disrupted ligament, ankle; collateral","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-05","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":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-06-05","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":"99174","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20912","name":"Remove cartilage for graft","description":"Cartilage graft; nasal septum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"54115","name":"Treatment of penis lesion","description":"Removal foreign body from deep penile tissue (eg, plastic implant)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34826","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92516","name":"Facial nerve function test","description":"Facial nerve function studies (eg, electroneuronography)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67875","name":"Closure of eyelid by suture","description":"Temporary closure of eyelids by suture (eg, frost suture)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15430","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"76880","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-06-05","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":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60281","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus; recurrent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4297","name":"Hydrophilic coat insert sup","description":"Intermittent urinary catheter; hydrophilic coating, with insertion supplies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33676","name":"Close mult vsd w/resection","description":"Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3207","name":"Hightop w/ supp/pronator jun","description":"Orthopedic shoe, hightop with supinator or pronator, junior","date_of_service":"2026-06-05","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":"36010","name":"Place catheter in vein","description":"Introduction of catheter, superior or inferior vena cava","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47525","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-05","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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28345","name":"Repair webbed toe(s)","description":"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"36440","name":"Bld push tfuj 2 yr/<","description":"Push transfusion, blood, 2 years or younger","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29358","name":"Appl long leg cast brace","description":"Application of long leg cast brace","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-06-05","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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"85576","name":"Blood platelet aggregation","description":"Platelet, aggregation (in vitro), each agent","date_of_service":"2026-06-05","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":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26842","name":"Thumb fusion with graft","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-06-05","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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-05","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":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38530","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, internal mammary node(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33471","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-06-05","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":"27134","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; both components, with or without autograft or allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-06-05","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":"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, furn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46211","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-06-05","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":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36511","name":"Apheresis wbc","description":"Therapeutic apheresis; for white blood cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21044","name":"Removal of jaw bone lesion","description":"Excision of malignant tumor of mandible;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-06-05","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":"20101","name":"Expl pentrg wound chest","description":"Exploration of penetrating wound (separate procedure); chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82308","name":"Assay of calcitonin","description":"Calcitonin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-06-05","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":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0288","name":"Recon, cta for surg plan","description":"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","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":"42806","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, survey for unknown primary lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31293","name":"Nsl/sins ndsc med&inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0112","name":"Potassium hydroxide preps","description":"All potassium hydroxide (koh) preparations","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"00740","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"C8902","name":"Mra w/o fol w/cont, abd","description":"Magnetic resonance angiography without contrast followed by with contrast, abdomen","date_of_service":"2026-06-05","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":"27005","name":"Tenotomy hip flexor open","description":"Tenotomy, hip flexor(s), open (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86816","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, single antigen","date_of_service":"2026-06-05","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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25825","name":"Arthrd wrist with autograft","description":"Arthrodesis, wrist; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-05","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":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"58974","name":"Embryo transfer intrauterine","description":"Embryo transfer, intrauterine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35540","name":"Art byp grft aortbifemoral","description":"Bypass graft, with vein; aortobifemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"53010","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97004","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33284","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-06-05","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":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-06-05","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":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-06-05","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":"80160","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15821","name":"Blepharp lwr eyelid fat pad","description":"Blepharoplasty, lower eyelid; with extensive herniated fat pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-06-05","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":"30520","name":"Repair of nasal septum","description":"Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-06-05","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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-05","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":"50593","name":"Perc cryo ablate renal tum","description":"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62163","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-05","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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86185","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57160","name":"Insert pessary/other device","description":"Fitting and insertion of pessary or other intravaginal support device","date_of_service":"2026-06-05","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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-05","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":"69715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77417","name":"Ther radiology port image(s)","description":"Therapeutic radiology port image(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25670","name":"Optx rdcrpl/ntrcrpl dislc 1+","description":"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"ATP23","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"22305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64713","name":"Revision of arm nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"68325","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-06-05","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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-05","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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61700","name":"Brain aneurysm repr simple","description":"Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-06-05","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":"33416","name":"Revise ventricle muscle","description":"Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis (eg, asymmetric septal hypertrophy)","date_of_service":"2026-06-05","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":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-06-05","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":"65782","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32800","name":"Repair lung hernia","description":"Repair lung hernia through chest wall","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","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":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-06-05","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82654","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54512","name":"Excise lesion testis","description":"Excision of extraparenchymal lesion of testis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-06-05","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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9502","name":"Tc99m tetrofosmin","description":"Technetium tc-99m tetrofosmin, diagnostic, per study dose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"47510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61524","name":"Removal of brain lesion","description":"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85175","name":"Blood clot lysis time","description":"Clot lysis time, whole blood dilution","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-06-05","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":"64470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"G6019","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45500","name":"Repair of rectum","description":"Proctoplasty; for stenosis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-06-05","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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"T5999","name":"Supply, nos","description":"Supply, not otherwise specified","date_of_service":"2026-06-05","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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-06-05","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":"G6009","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0761","name":"Nontherm electromgntc device","description":"Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device","date_of_service":"2026-06-05","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":"96102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-05","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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"89225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-06-05","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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27416","name":"Osteochondral knee autograft","description":"Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"50045","name":"Nephrotomy w/exploration","description":"Nephrotomy, with exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-05","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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51710","name":"Change of bladder tube","description":"Change of cystostomy tube; complicated","date_of_service":"2026-06-05","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":"54130","name":"Remove penis & nodes","description":"Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35492","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85597","name":"Phospholipid pltlt neutraliz","description":"Phospholipid neutralization; platelet","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32601","name":"Thoracoscopy diagnostic","description":"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy","date_of_service":"2026-06-05","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"25248","name":"Remove forearm foreign body","description":"Exploration with removal of deep foreign body, forearm or wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-05","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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-06-05","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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-06-05","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":"64577","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3207","name":"Hightop w/ supp/pronator jun","description":"Orthopedic shoe, hightop with supinator or pronator, junior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-06-05","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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-05","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":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-05","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":"15780","name":"Dermabrasion total face","description":"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-06-05","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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26490","name":"Revise thumb tendon","description":"Opponensplasty; superficialis tendon transfer type, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-05","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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"P9016","name":"Rbc leukocytes reduced","description":"Red blood cells, leukocytes reduced, each unit","date_of_service":"2026-06-05","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":"33786","name":"Repair arterial trunk","description":"Total repair, truncus arteriosus (rastelli type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-06-05","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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-05","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":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20220","name":"Bone biopsy trocar/ndl supfc","description":"Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-06-05","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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-06-05","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":"64410","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-05","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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"C1887","name":"Catheter, guiding","description":"Catheter, guiding (may include infusion/perfusion capability)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69605","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-06-05","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":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-06-05","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":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"64861","name":"Repair of arm nerves","description":"Suture of; brachial plexus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"99328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64861","name":"Repair of arm nerves","description":"Suture of; brachial plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42281","name":"Insertion palate prosthesis","description":"Insertion of pin-retained palatal prosthesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"57170","name":"Fitting of diaphragm/cap","description":"Diaphragm or cervical cap fitting with instructions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-06-05","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":"85097","name":"Bone marrow interpretation","description":"Bone marrow, smear interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"38300","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-06-05","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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-06-05","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":"26255","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35721","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-06-05","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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-06-05","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":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-06-05","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":"44900","name":"I&d appendix abscess open","description":"Incision and drainage of appendiceal abscess, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49656","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32607","name":"Thoracoscopy w/bx infiltrate","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22522","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"69670","name":"Remove mastoid air cells","description":"Mastoid obliteration (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"15758","name":"Free fascial flap microvasc","description":"Free fascial flap with microvascular anastomosis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27030","name":"Arthrotomy hip w/drainage","description":"Arthrotomy, hip, with drainage (eg, infection)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75676","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36516","name":"Apheresis immunoads slctv","description":"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-05","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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31624","name":"Dx bronchoscope/lavage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-06-05","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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"45309","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-06-05","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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82365","name":"Calculus spectroscopy","description":"Calculus; infrared spectroscopy","date_of_service":"2026-06-05","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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-06-05","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":"44615","name":"Intestinal stricturoplasty","description":"Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal obstruction","date_of_service":"2026-06-05","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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-06-05","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":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-05","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":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-06-05","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":"96446","name":"Chemotx admn pertl cav impl","description":"Chemotherapy administration into the peritoneal cavity via implanted port or catheter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75665","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57112","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61692","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, complex","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61750","name":"Incise skull/brain biopsy","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26530","name":"Revise knuckle joint","description":"Arthroplasty, metacarpophalangeal joint; each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-06-05","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":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-06-05","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":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-06-05","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":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-05","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":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21270","name":"Augmentation cheek bone","description":"Malar augmentation, prosthetic material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92970","name":"Cardioassist internal","description":"Cardioassist-method of circulatory assist; internal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-05","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":"58541","name":"Lsh uterus 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-06-05","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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50800","name":"Implant ureter in bowel","description":"Ureteroenterostomy, direct anastomosis of ureter to intestine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43030","name":"Cricopharyngeal myotomy","description":"Cricopharyngeal myotomy","date_of_service":"2026-06-05","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":"48102","name":"Needle biopsy pancreas","description":"Biopsy of pancreas, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-06-05","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":"91012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44705","name":"Prepare fecal microbiota","description":"Preparation of fecal microbiota for instillation, including assessment of donor specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-05","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":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"54535","name":"Extensive testis surgery","description":"Orchiectomy, radical, for tumor; with abdominal exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4100","name":"Food thickener oral","description":"Food thickener, administered orally, per ounce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77523","name":"Proton trmt intermediate","description":"Proton treatment delivery; intermediate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26437","name":"Realignment of tendons","description":"Realignment of extensor tendon, hand, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46221","name":"Ligation of hemorrhoid(s)","description":"Hemorrhoidectomy, internal, by rubber band ligation(s)","date_of_service":"2026-06-05","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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86022","name":"Platelet antibodies","description":"Antibody identification; platelet antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-06-05","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":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90804","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57307","name":"Fistula repair & colostomy","description":"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-05","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":"36015","name":"Place catheter in artery","description":"Selective catheter placement, segmental or subsegmental pulmonary artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37209","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33422","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; open heart, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28505","name":"Treat big toe fracture","description":"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27557","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82979","name":"Assay rbc glutathione","description":"Glutathione reductase, rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84302","name":"Assay of sweat sodium","description":"Sodium; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92577","name":"Stenger test speech","description":"Stenger test, speech","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-05","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":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82615","name":"Test for urine cystines","description":"Cystine and homocystine, urine, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L7274","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"24342","name":"Repair of ruptured tendon","description":"Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33403","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-05","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"53400","name":"Revise urethra stage 1","description":"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, johannsen type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0430","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-06-05","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":"96523","name":"Irrig drug delivery device","description":"Irrigation of implanted venous access device for drug delivery systems","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-05","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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":"G6014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-06-05","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":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29710","name":"Rmvl/bivlv sho/hip spica","description":"Removal or bivalving; shoulder or hip spica, minerva, or risser jacket, etc.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-06-05","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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"T4541","name":"Large disposable underpad","description":"Incontinence product, disposable underpad, large, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-06-05","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":"69955","name":"Release facial nerve","description":"Total facial nerve decompression and/or repair (may include graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26591","name":"Repair muscles of hand","description":"Repair, intrinsic muscles of hand, each muscle","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27893","name":"Decompression of leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86741","name":"Neisseria meningitidis","description":"Antibody; neisseria meningitidis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"61548","name":"Removal of pituitary gland","description":"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88263","name":"Chromosome analysis 45","description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-05","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":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"80103","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4529","name":"Ped size brief/diaper sm/med","description":"Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49000","name":"Exploration of abdomen","description":"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55000","name":"Drainage of hydrocele","description":"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"A9282","name":"Wig any type","description":"Wig, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-06-05","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":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-06-05","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":"54640","name":"Orchiopexy ingun/scrot appr","description":"Orchiopexy, inguinal or scrotal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83906","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-06-05","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":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-06-05","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":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23802","name":"Arthrd glenohumeral jt w/grf","description":"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0507","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"00810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"57288","name":"Repair bladder defect","description":"Sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"29035","name":"Appl body cast sho to hips","description":"Application of body cast, shoulder to hips;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"42205","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only","date_of_service":"2026-06-05","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":"85291","name":"Clot factor xiii fibrin scrn","description":"Clotting; factor xiii (fibrin stabilizing), screen solubility","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3252","name":"Shoe molded plastazote cust","description":"Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"90826","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4180","name":"Parenteral sol carb > 50%","description":"Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix","date_of_service":"2026-06-05","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":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-05","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27438","name":"Revise kneecap with implant","description":"Arthroplasty, patella; with prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27405","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; collateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"ATP23","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31087","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0436","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27705","name":"Osteotomy tibia","description":"Osteotomy; tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-05","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":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25335","name":"Centralization wrist on ulna","description":"Centralization of wrist on ulna (eg, radial club hand)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86644","name":"Cmv antibody","description":"Antibody; cytomegalovirus (cmv)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42330","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86789","name":"West nile virus antibody","description":"Antibody; west nile virus","date_of_service":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"23000","name":"Rmvl sbdltd clcreous dep opn","description":"Removal of subdeltoid calcareous deposits, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44602","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49654","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-06-05","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":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"53601","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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":"20926","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45990","name":"Surg dx exam anorectal","description":"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82607","name":"Vitamin b-12","description":"Cyanocobalamin (vitamin b-12);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"82784","name":"Assay iga/igd/igg/igm each","description":"Gammaglobulin (immunoglobulin); iga, igd, igg, igm, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47562","name":"Laparoscopic cholecystectomy","description":"Laparoscopy, surgical; cholecystectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-06-05","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":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85280","name":"Clot factor xii hageman","description":"Clotting; factor xii (hageman)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-06-05","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":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-05","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"24940","name":"Revision of upper arm","description":"Cineplasty, upper extremity, complete procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-05","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"45334","name":"Sigmoidoscopy for bleeding","description":"Sigmoidoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-06-05","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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","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":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44207","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25375","name":"Revise radius & ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius and ulna","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"37210","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75558","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-06-05","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":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0463","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"25375","name":"Revise radius & ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82946","name":"Glucagon tolerance test","description":"Glucagon tolerance test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35226","name":"Repair blood vessel dir lxtr","description":"Repair blood vessel, direct; lower extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-06-05","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":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-05","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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-05","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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-05","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":"61686","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26545","name":"Reconstruct finger joint","description":"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21246","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; complete","date_of_service":"2026-06-05","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":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4500","name":"Below knee surgical stocking","description":"Surgical stockings below knee length, each","date_of_service":"2026-06-05","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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95973","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"49323","name":"Laparo drain lymphocele","description":"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-06-05","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":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77408","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47554","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with removal of calculus/calculi","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"84127","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32540","name":"Removal of lung lesion","description":"Extrapleural enucleation of empyema (empyemectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19304","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"41100","name":"Biopsy of tongue","description":"Biopsy of tongue; anterior two-thirds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-06-05","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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54056","name":"Cryosurgery penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29807","name":"Sho arthrs srg rpr slap les","description":"Arthroscopy, shoulder, surgical; repair of slap lesion","date_of_service":"2026-06-05","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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"80162","name":"Assay of digoxin total","description":"Digoxin; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-05","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":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-06-05","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":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35304","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"65765","name":"Keratophakia","description":"Keratophakia","date_of_service":"2026-06-05","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":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-06-05","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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82746","name":"Assay of folic acid serum","description":"Folic acid; serum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","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":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65756","name":"Corneal trnspl endothelial","description":"Keratoplasty (corneal transplant); endothelial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81284","name":"Fxn gene detc abnor alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29905","name":"Subtalar arthro w/exc","description":"Arthroscopy, subtalar joint, surgical; with synovectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-05","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":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25490","name":"Prophylactic tx radius","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43228","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","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":"15740","name":"Island pedicle flap graft","description":"Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-06-05","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"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92020","name":"Gonioscopy","description":"Gonioscopy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-06-05","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":"25246","name":"Injection for wrist x-ray","description":"Injection procedure for wrist arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37235","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69320","name":"Rebuild outer ear canal","description":"Reconstruction external auditory canal for congenital atresia, single stage","date_of_service":"2026-06-05","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":"27220","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-06-05","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":"83670","name":"Assay of lap enzyme","description":"Leucine aminopeptidase (lap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33241","name":"Remove pulse generator","description":"Removal of implantable defibrillator pulse generator only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49610","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10160","name":"Pnxr aspir absc hmtma bulla","description":"Puncture aspiration of abscess, hematoma, bulla, or cyst","date_of_service":"2026-06-05","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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-06-05","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":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32940","name":"Revision of lung","description":"Pneumonolysis, extraperiosteal, including filling or packing procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-05","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":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-06-05","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":"24220","name":"Injection px for elbow arthg","description":"Injection procedure for elbow arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-05","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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-05","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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84110","name":"Assay of porphobilinogen","description":"Porphobilinogen, urine; quantitative","date_of_service":"2026-06-05","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":"0147T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69020","name":"Drg xtrnl aud canal abscess","description":"Drainage external auditory canal, abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-05","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":"31051","name":"Sphenoid sinus surgery","description":"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"2026-06-05","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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-05","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":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4246","name":"Betadine/phisohex solution","description":"Betadine or phisohex solution, per pint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82649","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-05","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":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-06-05","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":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11720","name":"Debride nail 1-5","description":"Debridement of nail(s) by any method(s); 1 to 5","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"61545","name":"Excision of brain tumor","description":"Craniotomy with elevation of bone flap; for excision of craniopharyngioma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15782","name":"Dermabrasion other than face","description":"Dermabrasion; regional, other than face","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51590","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84588","name":"Assay of vasopressin","description":"Vasopressin (antidiuretic hormone, adh)","date_of_service":"2026-06-05","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":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-06-05","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":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51940","name":"Correction of bladder defect","description":"Closure, exstrophy of bladder","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"36831","name":"Open thrombect av fistula","description":"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-05","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":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43193","name":"Esophagoscp rig trnso biopsy","description":"Esophagoscopy, rigid, transoral; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85347","name":"Coagulation time activated","description":"Coagulation time; activated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87900","name":"Phenotype infect agent drug","description":"Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L1520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31575","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, flexible; diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38212","name":"Rbc depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; red blood cell removal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50593","name":"Perc cryo ablate renal tum","description":"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"29530","name":"Strapping of knee","description":"Strapping; knee","date_of_service":"2026-06-05","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":"37232","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86485","name":"Skin test candida","description":"Skin test; candida","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-05","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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75685","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-06-05","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":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-06-05","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":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-06-05","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":"27324","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"11975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4927","name":"Non-sterile gloves","description":"Gloves, non-sterile, per 100","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31561","name":"Larynscop remve cart + scop","description":"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0244","name":"Toilet seat raised","description":"Raised toilet seat","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"38204","name":"Bl donor search management","description":"Management of recipient hematopoietic progenitor cell donor search and cell acquisition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90810","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64910","name":"Nerve repair w/allograft","description":"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35601","name":"Bpg com crtd-ipsi int crtd","description":"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-05","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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23473","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15331","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-06-05","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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"21044","name":"Removal of jaw bone lesion","description":"Excision of malignant tumor of mandible;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0484T","name":"Tmvi transthoracic exposure","description":"Transcatheter mitral valve implantation/replacement (tmvi) with prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33414","name":"Repair of aortic valve","description":"Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84078","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline; heat stable (total not included)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G2061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27394","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, 1 leg","date_of_service":"2026-06-05","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":"99364","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49580","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0212T","name":"Compre audiometry evaluation","description":"Comprehensive audiometry threshold evaluation and speech recognition (0209t, 0211t combined), automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-06-05","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":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-06-05","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":"42825","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; younger than age 12","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87550","name":"Mycobacteria dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, direct probe technique","date_of_service":"2026-06-05","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"67141","name":"Proph rta dtchmnt crtx dthrm","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27766","name":"Optx medial ankle fx","description":"Open treatment of medial malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54110","name":"Treatment of penis lesion","description":"Excision of penile plaque (peyronie disease);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-06-05","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":"50021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-05","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4465","name":"Non-elastic extremity binder","description":"Non-elastic binder for extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9275","name":"Disp home glucose monitor","description":"Home glucose disposable monitor, includes test strips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-06-05","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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-05","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":"99442","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83045","name":"Hgb methemoglobin qual","description":"Hemoglobin; methemoglobin, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27654","name":"Repair of achilles tendon","description":"Repair, secondary, achilles tendon, with or without graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28575","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-06-05","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"33516","name":"Cabg vein six or more","description":"Coronary artery bypass, vein only; 6 or more coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27726","name":"Repair fibula nonunion","description":"Repair of fibula nonunion and/or malunion with internal fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0298T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82085","name":"Assay of aldolase","description":"Aldolase","date_of_service":"2026-06-05","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92995","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28062","name":"Removal of foot fascia","description":"Fasciectomy, plantar fascia; radical (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83892","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92582","name":"Conditioning play audiometry","description":"Conditioning play audiometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93514","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77406","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82106","name":"Alpha-fetoprotein amniotic","description":"Alpha-fetoprotein (afp); amniotic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","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":"69220","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36512","name":"Apheresis rbc","description":"Therapeutic apheresis; for red blood cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45321","name":"Proctosigmoidoscopy volvul","description":"Proctosigmoidoscopy, rigid; with decompression of volvulus","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84087","name":"Assay phosphohexose enzymes","description":"Phosphohexose isomerase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"91313","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-06-05","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":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-06-05","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":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"11975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-06-05","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":"65105","name":"Remove eye/attach implant","description":"Enucleation of eye; with implant, muscles attached to implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83491","name":"Asy hydroxycorticosteroids17","description":"Hydroxycorticosteroids, 17- (17-ohcs)","date_of_service":"2026-06-05","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":"27330","name":"Biopsy knee joint lining","description":"Arthrotomy, knee; with synovial biopsy only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65760","name":"Keratomileusis","description":"Keratomileusis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"U0001","name":"2019-ncov diagnostic p","description":"Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel","date_of_service":"2026-06-05","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":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45020","name":"Drainage of rectal abscess","description":"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94644","name":"Cont inhlj tx 1st hour","description":"Continuous inhalation treatment with aerosol medication for acute airway obstruction; first hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-05","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":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36513","name":"Apheresis platelets","description":"Therapeutic apheresis; for platelets","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","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":"82380","name":"Assay of carotene","description":"Carotene","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-05","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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77079","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84376","name":"Sugars single qual","description":"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29530","name":"Strapping of knee","description":"Strapping; knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84220","name":"Assay of pyruvate kinase","description":"Pyruvate kinase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27442","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43228","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27625","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49540","name":"Repair lumbar hernia","description":"Repair lumbar hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-06-05","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":"83020","name":"Hemoglobin electrophoresis","description":"Hemoglobin fractionation and quantitation; electrophoresis (eg, a2, s, c, and/or f)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33961","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35331","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; abdominal aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84630","name":"Assay of zinc","description":"Zinc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27405","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; collateral","date_of_service":"2026-06-05","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77032","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21209","name":"Reduction of facial bones","description":"Osteoplasty, facial bones; reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"45111","name":"Partial removal of rectum","description":"Proctectomy; partial resection of rectum, transabdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32480","name":"Partial removal of lung","description":"Removal of lung, other than pneumonectomy; single lobe (lobectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4641","name":"Radiopharm dx agent noc","description":"Radiopharmaceutical, diagnostic, not otherwise classified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","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":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34825","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-05","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":"01682","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"15819","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-06-05","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":"47612","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with choledochoenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43219","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31297","name":"Nsl/sins ndsc surg sphn sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium","date_of_service":"2026-06-05","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":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53850","name":"Prostatic microwave thermotx","description":"Transurethral destruction of prostate tissue; by microwave thermotherapy","date_of_service":"2026-06-05","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":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-06-05","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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26706","name":"Pin knuckle dislocation","description":"Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55500","name":"Removal of hydrocele","description":"Excision of hydrocele of spermatic cord, unilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64435","name":"Njx aa&/strd paracrv nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"46220","name":"Excise anal ext tag/papilla","description":"Excision of single external papilla or tag, anus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64577","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"20661","name":"Application halo cranial","description":"Application of halo, including removal; cranial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-06-05","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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21440","name":"Cltx mndblr/max alv ridge fx","description":"Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-05","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":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"58120","name":"Dilation and curettage","description":"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-05","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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-06-05","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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-06-05","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":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64721","name":"Carpal tunnel surgery","description":"Neuroplasty and/or transposition; median nerve at carpal tunnel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-05","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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"63172","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4648","name":"Implantable tissue marker","description":"Tissue marker, implantable, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0246T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50840","name":"Replace ureter by bowel","description":"Replacement of all or part of ureter by intestine segment, including intestine anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"29125","name":"Appl short arm splint static","description":"Application of short arm splint (forearm to hand); static","date_of_service":"2026-06-05","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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-05","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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49900","name":"Repair of abdominal wall","description":"Suture, secondary, of abdominal wall for evisceration or dehiscence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43327","name":"Esoph fundoplasty lap","description":"Esophagogastric fundoplasty partial or complete; laparotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"86885","name":"Coombs test indirect qual","description":"Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell","date_of_service":"2026-06-05","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":"75722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V5362","name":"Speech screening","description":"Speech screening","date_of_service":"2026-06-05","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":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"33271","name":"Insj subq impltbl dfb elctrd","description":"Insertion of subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26665","name":"Treat thumb fracture","description":"Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27500","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34471","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; subclavian vein, by neck incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-05","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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60605","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; with excision of carotid artery","date_of_service":"2026-06-05","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-05","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":"69905","name":"Remove inner ear","description":"Labyrinthectomy; transcanal","date_of_service":"2026-06-05","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":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64622","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93526","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-06-05","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":"27395","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80192","name":"Assay of procainamide","description":"Procainamide; with metabolites (eg, n-acetyl procainamide)","date_of_service":"2026-06-05","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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82306","name":"Vitamin d 25 hydroxy","description":"Vitamin d; 25 hydroxy, includes fraction(s), if performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23900","name":"Interthoracoscplr amputation","description":"Interthoracoscapular amputation (forequarter)","date_of_service":"2026-06-05","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":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86821","name":"Lymphocyte culture mixed","description":"Hla typing; lymphocyte culture, mixed (mlc)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95833","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32550","name":"Insert pleural cath","description":"Insertion of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-05","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":"26477","name":"Tendon shortening","description":"Shortening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-06-05","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":"44650","name":"Repair bowel fistula","description":"Closure of enteroenteric or enterocolic fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51865","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"G0423","name":"Intens cardiac rehab no exer","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41510","name":"Tongue to lip surgery","description":"Suture of tongue to lip for micrognathia (douglas type procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-06-05","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":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44322","name":"Colostomy with biopsies","description":"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24365","name":"Reconstruct head of radius","description":"Arthroplasty, radial head;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92569","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1788","name":"Port, indwelling, imp","description":"Port, indwelling (implantable)","date_of_service":"2026-06-05","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":"82746","name":"Assay of folic acid serum","description":"Folic acid; serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93231","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92140","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-06-05","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":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80166","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60271","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; cervical approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-06-05","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":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"19301","name":"Partial mastectomy","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"89310","name":"Semen analysis w/count","description":"Semen analysis; motility and count (not including huhner test)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93233","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-06-05","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":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"82491","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-06-05","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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86813","name":"Hla typing a b or c","description":"Hla typing; a, b, or c, multiple antigens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0269T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31370","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); horizontal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35231","name":"Repair blvsl vn grf neck","description":"Repair blood vessel with vein graft; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33241","name":"Remove pulse generator","description":"Removal of implantable defibrillator pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-05","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":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99334","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-06-05","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":"20660","name":"Apply rem fixation device","description":"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-06-05","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":"69401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"58673","name":"Laparoscopy salpingostomy","description":"Laparoscopy, surgical; with salpingostomy (salpingoneostomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28210","name":"Repair/graft of foot tendon","description":"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90880","name":"Hypnotherapy","description":"Hypnotherapy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29435","name":"Appl patllr tdn bearing cast","description":"Application of patellar tendon bearing (ptb) cast","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-06-05","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-06-05","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":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32669","name":"Thoracoscopy remove segment","description":"Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-06-05","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":"G6003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23462","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with coracoid process transfer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86905","name":"Blood typing rbc antigens","description":"Blood typing, serologic; rbc antigens, other than abo or rh (d), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26686","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction","date_of_service":"2026-06-05","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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"21215","name":"Lower jaw bone graft","description":"Graft, bone; mandible (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"27477","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9041","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-05","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-06-05","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":"33917","name":"Repair pulmonary artery","description":"Repair of pulmonary artery stenosis by reconstruction with patch or graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87515","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29886","name":"Arthrs knee surg drlg od les","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20902","name":"Removal of bone for graft","description":"Bone graft, any donor area; major or large","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33611","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29828","name":"Sho arthrs srg bicp tenodsis","description":"Arthroscopy, shoulder, surgical; biceps tenodesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64834","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; hand or foot, common sensory nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64722","name":"Decompression unspec nerve","description":"Decompression; unspecified nerve(s) (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-06-05","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":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86747","name":"Parvovirus antibody","description":"Antibody; parvovirus","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57558","name":"D&c of cervical stump","description":"Dilation and curettage of cervical stump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"89100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"32657","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-05","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":"33202","name":"Insert epicard eltrd open","description":"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-06-05","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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-05","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90809","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-05","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":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27122","name":"Reconstruction of hip socket","description":"Acetabuloplasty; resection, femoral head (eg, girdlestone procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-06-05","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":"33724","name":"Repair venous anomaly","description":"Repair of isolated partial anomalous pulmonary venous return (eg, scimitar syndrome)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15732","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-06-05","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"60254","name":"Extensive thyroid surgery","description":"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51710","name":"Change of bladder tube","description":"Change of cystostomy tube; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-06-05","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":"87477","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64752","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75662","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26525","name":"Release finger contracture","description":"Capsulectomy or capsulotomy; interphalangeal joint, each joint","date_of_service":"2026-06-05","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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-05","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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-05","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"96542","name":"Chemotherapy injection","description":"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents","date_of_service":"2026-06-05","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":"35903","name":"Excision graft extremity","description":"Excision of infected graft; extremity","date_of_service":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"Q4097","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88375","name":"Optical endomicroscpy interp","description":"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-06-05","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":"0564T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"66720","name":"Destruction ciliary body","description":"Ciliary body destruction; cryotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93668","name":"Peripheral vascular rehab","description":"Peripheral arterial disease (pad) rehabilitation, per session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-06-05","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":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26261","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L6025","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19112","name":"Excise breast duct fistula","description":"Excision of lactiferous duct fistula","date_of_service":"2026-06-05","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":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-05","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":"36260","name":"Insertion of infusion pump","description":"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29035","name":"Appl body cast sho to hips","description":"Application of body cast, shoulder to hips;","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3160","name":"Shoe styled positioning dev","description":"Foot, adjustable shoe-styled positioning device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50750","name":"Fusion of ureter & kidney","description":"Ureterocalycostomy, anastomosis of ureter to renal calyx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-06-05","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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82960","name":"Test for g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69020","name":"Drg xtrnl aud canal abscess","description":"Drainage external auditory canal, abscess","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93237","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83003","name":"Assay growth hormone (hgh)","description":"Growth hormone, human (hgh) (somatotropin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29830","name":"Elbow arthroscopy","description":"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67550","name":"Insert eye socket implant","description":"Orbital implant (implant outside muscle cone); insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-05","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":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"26010","name":"Drainage of finger abscess","description":"Drainage of finger abscess; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0549T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27590","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-06-05","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4932","name":"Reusable rectal thermometer","description":"Rectal thermometer, reusable, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"97532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"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 observ","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-06-05","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":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"52283","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with steroid injection into stricture","date_of_service":"2026-06-05","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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87582","name":"M.pneumon dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-05","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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4245","name":"Alcohol wipes per box","description":"Alcohol wipes, per box","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82652","name":"Vit d 1 25-dihydroxy","description":"Vitamin d; 1, 25 dihydroxy, includes fraction(s), if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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":"88235","name":"Tissue culture placenta","description":"Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells","date_of_service":"2026-06-05","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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90804","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-06-05","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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-05","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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5266","name":"Battery for hearing device","description":"Battery for use in hearing device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30420","name":"Reconstruction of nose","description":"Rhinoplasty, primary; including major septal repair","date_of_service":"2026-06-05","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":"82163","name":"Assay of angiotensin ii","description":"Angiotensin ii","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28320","name":"Repair of foot bones","description":"Repair, nonunion or malunion; tarsal bones","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21088","name":"Impres&prep facial prosth","description":"Impression and custom preparation; facial prosthesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49611","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); second stage","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-06-05","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26508","name":"Release thumb contracture","description":"Release of thenar muscle(s) (eg, thumb contracture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77525","name":"Proton treatment complex","description":"Proton treatment delivery; complex","date_of_service":"2026-06-05","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":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-06-05","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":"29015","name":"Appl rissr jacket bdy w/head","description":"Application of risser jacket, localizer, body; including head","date_of_service":"2026-06-05","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":"82696","name":"Assay of etiocholanolone","description":"Etiocholanolone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83615","name":"Lactate (ld) (ldh) enzyme","description":"Lactate dehydrogenase (ld), (ldh);","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65270","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure","date_of_service":"2026-06-05","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":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20922","name":"Removal of fascia for graft","description":"Fascia lata graft; by incision and area exposure, complex or sheet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-05","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":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"62294","name":"Injection into spinal artery","description":"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-05","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":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43600","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"41530","name":"Tongue base vol reduction","description":"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28740","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, single joint","date_of_service":"2026-06-05","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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","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":"L3216","name":"Orthoped ladies shoes dpth i","description":"Orthopedic footwear, ladies shoe, depth inlay, each","date_of_service":"2026-06-05","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":"85306","name":"Clot inhibit prot s free","description":"Clotting inhibitors or anticoagulants; protein s, free","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69806","name":"Explore inner ear","description":"Endolymphatic sac operation; with shunt","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32800","name":"Repair lung hernia","description":"Repair lung hernia through chest wall","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31730","name":"Intro windpipe wire/tube","description":"Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","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":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61640","name":"Dilate ic vasospasm init","description":"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65093","name":"Revise eye with implant","description":"Evisceration of ocular contents; with implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-06-05","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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-05","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":"22851","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36013","name":"Place catheter in artery","description":"Introduction of catheter, right heart or main pulmonary artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87552","name":"Mycobacteria dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, quantification","date_of_service":"2026-06-05","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":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92653","name":"Aep neurodiagnostic i&r","description":"Auditory evoked potentials; neurodiagnostic, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-06-05","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":"35665","name":"Bpg iliofemoral","description":"Bypass graft, with other than vein; iliofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76497","name":"Unlisted ct procedure","description":"Unlisted computed tomography procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-05","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":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"26530","name":"Revise knuckle joint","description":"Arthroplasty, metacarpophalangeal joint; each joint","date_of_service":"2026-06-05","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":"83902","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36825","name":"Artery-vein autograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"62310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33891","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64626","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-06-05","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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-06-05","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":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-06-05","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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36511","name":"Apheresis wbc","description":"Therapeutic apheresis; for white blood cells","date_of_service":"2026-06-05","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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"15922","name":"Exc coccygl pr ulc flap clsr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42835","name":"Removal of adenoids","description":"Adenoidectomy, secondary; younger than age 12","date_of_service":"2026-06-05","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":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78596","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51050","name":"Removal of bladder stone","description":"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0478T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25622","name":"Cltx carpl scphd fx w/o mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-06-05","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"31552","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61697","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-05","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":"49565","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85441","name":"Heinz bodies direct","description":"Heinz bodies; direct","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-06-05","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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-06-05","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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67908","name":"Repair eyelid defect","description":"Repair of blepharoptosis; conjunctivo-tarso-mullers muscle-levator resection (eg, fasanella-servat type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44180","name":"Lap enterolysis","description":"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"55150","name":"Removal of scrotum","description":"Resection of scrotum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31561","name":"Larynscop remve cart + scop","description":"Laryngoscopy, direct, operative, with arytenoidectomy; with operating microscope or telescope","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66680","name":"Repair iris & ciliary body","description":"Repair of iris, ciliary body (as for iridodialysis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-05","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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-05","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":"57111","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-05","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":"94669","name":"Mechanical chest wall oscill","description":"Mechanical chest wall oscillation to facilitate lung function, per session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41530","name":"Tongue base vol reduction","description":"Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46700","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; adult","date_of_service":"2026-06-05","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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-06-05","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":"86806","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; without titration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21083","name":"Impres&prep paltl lft prosth","description":"Impression and custom preparation; palatal lift prosthesis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75954","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"53425","name":"Reconstruct urethra stage 2","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27613","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93232","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83913","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"69220","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)","date_of_service":"2026-06-05","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":"95065","name":"Dir nsl mucous membrane test","description":"Direct nasal mucous membrane test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-06-05","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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-06-05","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":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-06-05","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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"U0004","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26862","name":"Fusion/graft of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-05","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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-05","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":"33261","name":"Ablate heart dysrhythm focus","description":"Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"54690","name":"Laparoscopy orchiectomy","description":"Laparoscopy, surgical; orchiectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-06-05","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":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25426","name":"Repair/graft radius & ulna","description":"Repair of defect with autograft; radius and ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24151","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25394","name":"Repair carpal bone shorten","description":"Osteoplasty, carpal bone, shortening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"56821","name":"Colposcopy vulva w/biopsy","description":"Colposcopy of the vulva; with biopsy(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"15341","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"90823","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20970","name":"Bone/skin graft iliac crest","description":"Free osteocutaneous flap with microvascular anastomosis; iliac crest","date_of_service":"2026-06-05","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":"82651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27178","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61543","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy","date_of_service":"2026-06-05","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":"27125","name":"Partial hip replacement","description":"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49324","name":"Lap insert tunnel ip cath","description":"Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter","date_of_service":"2026-06-05","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":"25565","name":"Cltx rdl&uln shft fx w/mnpj","description":"Closed treatment of radial and ulnar shaft fractures; with manipulation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-06-05","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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-06-05","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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-05","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":"82489","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-06-05","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":"33726","name":"Repair pul venous stenosis","description":"Repair of pulmonary venous stenosis","date_of_service":"2026-06-05","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-06-05","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":"67030","name":"Incise inner eye strands","description":"Discission of vitreous strands (without removal), pars plana approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-06-05","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-05","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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92547","name":"Supplemental electrical test","description":"Use of vertical electrodes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64570","name":"Remove vagus n eltrd","description":"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"40525","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with local flap (eg, estlander or fan)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93541","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86705","name":"Hep b core antibody igm","description":"Hepatitis b core antibody (hbcab); igm antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3909","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82390","name":"Assay of ceruloplasmin","description":"Ceruloplasmin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-06-05","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":"87267","name":"Enterovirus antibody dfa","description":"Infectious agent antigen detection by immunofluorescent technique; enterovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"52283","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with steroid injection into stricture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99441","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","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":"99488","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92990","name":"Revision of pulmonary valve","description":"Percutaneous balloon valvuloplasty; pulmonary valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-06-05","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":"26498","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; all 4 fingers","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10160","name":"Pnxr aspir absc hmtma bulla","description":"Puncture aspiration of abscess, hematoma, bulla, or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-05","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":"42826","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; age 12 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35305","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibial or peroneal artery, initial vessel","date_of_service":"2026-06-05","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":"15300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30450","name":"Revision of nose","description":"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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",""]}],"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-06-05","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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-05","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":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77413","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"CPT","billing_code_type_version":"2026","billing_code":"66220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67105","name":"Repair detached retina pc","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"25447","name":"Arthrp ntrcrp/crp/mtcr ntrps","description":"Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-06-05","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":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69710","name":"Implant/replace hearing aid","description":"Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28294","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-06-05","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":"93651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","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":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50700","name":"Revision of ureter","description":"Ureteroplasty, plastic operation on ureter (eg, stricture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-06-05","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":"21616","name":"Exc 1st&/crv rib w/sympth","description":"Excision first and/or cervical rib; with sympathectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23420","name":"Repair of shoulder","description":"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)","date_of_service":"2026-06-05","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":"27479","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-05","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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83840","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"55150","name":"Removal of scrotum","description":"Resection of scrotum","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-06-05","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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-05","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":"94370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36591","name":"Draw blood off venous device","description":"Collection of blood specimen from a completely implantable venous access device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","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":"86200","name":"Ccp antibody","description":"Cyclic citrullinated peptide (ccp), antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"65420","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92070","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64782","name":"Remove limb nerve lesion","description":"Excision of neuroma; hand or foot, except digital nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33211","name":"Insert card electrodes dual","description":"Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","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":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-06-05","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":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"P9037","name":"Plate pheres leukoredu irrad","description":"Platelets, pheresis, leukocytes reduced, irradiated, each unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-06-05","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":"29882","name":"Arthrs kne srg mnisc rpr m/l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33243","name":"Remove eltrd/thoracotomy","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-05","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"33237","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30140","name":"Resect inferior turbinate","description":"Submucous resection inferior turbinate, partial or complete, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-06-05","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":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-05","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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.0,"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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64834","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; hand or foot, common sensory nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","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":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0507","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"53444","name":"Insert tandem cuff","description":"Insertion of tandem cuff (dual cuff)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28173","name":"Resect metatarsal tumor","description":"Radical resection of tumor; metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35549","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-05","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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-05","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":"29914","name":"Hip arthro w/femoroplasty","description":"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)","date_of_service":"2026-06-05","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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-06-05","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":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29806","name":"Sho arthrs srg capsulorraphy","description":"Arthroscopy, shoulder, surgical; capsulorrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45345","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83898","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"44021","name":"Decompress small bowel","description":"Enterotomy, small intestine, other than duodenum; for decompression (eg, baker tube)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","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":"27445","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"73542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"32820","name":"Reconstruct injured chest","description":"Major reconstruction, chest wall (posttraumatic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4931","name":"Reusable oral thermometer","description":"Oral thermometer, reusable, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0503T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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":"41820","name":"Excision gum each quadrant","description":"Gingivectomy, excision gingiva, each quadrant","date_of_service":"2026-06-05","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":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11977","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"40831","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; over 2.5 cm or complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0700","name":"Safety equipment","description":"Safety equipment, device or accessory, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"54400","name":"Insert semi-rigid prosthesis","description":"Insertion of penile prosthesis; non-inflatable (semi-rigid)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-06-05","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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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 exam","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"V5020","name":"Conformity evaluation","description":"Conformity evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"26650","name":"Treat thumb fracture","description":"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"28126","name":"Partial removal of toe","description":"Resection, partial or complete, phalangeal base, each toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25426","name":"Repair/graft radius & ulna","description":"Repair of defect with autograft; radius and ulna","date_of_service":"2026-06-05","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":"82030","name":"Assay of adp & amp","description":"Adenosine, 5-monophosphate, cyclic (cyclic amp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"ATP21","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82340","name":"Assay of calcium in urine","description":"Calcium; urine quantitative, timed specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-06-05","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":"49021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-06-05","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-06-05","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":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99148","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G6017","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65765","name":"Keratophakia","description":"Keratophakia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90811","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28445","name":"Optx talus fracture","description":"Open treatment of talus fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49568","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","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":"61750","name":"Incise skull/brain biopsy","description":"Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-06-05","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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64859","name":"Nerve surgery","description":"Suture of each additional major peripheral nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4911","name":"Drain bag/bottle","description":"Drain bag/bottle, for dialysis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64792","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; extensive (including malignant type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31574","name":"Largsc w/njx augmentation","description":"Laryngoscopy, flexible; with injection(s) for augmentation (eg, percutaneous, transoral), unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-06-05","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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23525","name":"Cltx strnclav dislc w/mnpj","description":"Closed treatment of sternoclavicular dislocation; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30110","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), simple","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86741","name":"Neisseria meningitidis","description":"Antibody; neisseria meningitidis","date_of_service":"2026-06-05","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":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28293","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82380","name":"Assay of carotene","description":"Carotene","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22524","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","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":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-06-05","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":"32408","name":"Core ndl bx lng/med perq","description":"Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed","date_of_service":"2026-06-05","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":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93875","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"83008","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-06-05","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":"42409","name":"Drainage of salivary cyst","description":"Marsupialization of sublingual salivary cyst (ranula)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"39531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"36640","name":"Insertion catheter artery","description":"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32215","name":"Treat chest lining","description":"Pleural scarification for repeat pneumothorax","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88738","name":"Hgb quant transcutaneous","description":"Hemoglobin (hgb), quantitative, transcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21452","name":"Perq tx mndblr fx xtrnl fixj","description":"Percutaneous treatment of mandibular fracture, with external fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27860","name":"Fixation of ankle joint","description":"Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36819","name":"Av fuse uppr arm basilic","description":"Arteriovenous anastomosis, open; by upper arm basilic vein transposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21121","name":"Geniop sldg osteot 1","description":"Genioplasty; sliding osteotomy, single piece","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-06-05","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":"36593","name":"Declot vascular device","description":"Declotting by thrombolytic agent of implanted vascular access device or catheter","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26418","name":"Repair finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon","date_of_service":"2026-06-05","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":"27301","name":"Drain thigh/knee lesion","description":"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region","date_of_service":"2026-06-05","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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54690","name":"Laparoscopy orchiectomy","description":"Laparoscopy, surgical; orchiectomy","date_of_service":"2026-06-05","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":"58550","name":"Laparo-asst vag hysterectomy","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2291","name":"Planar back for ped size wc","description":"Back, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-05","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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"61250","name":"Burr hole/treph sttl expl","description":"Burr hole(s) or trephine, supratentorial, exploratory, not followed by other surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89220","name":"Sputum specimen collection","description":"Sputum, obtaining specimen, aerosol induced technique (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4088","name":"Gastro/jejuno tube, low-pro","description":"Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23470","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; hemiarthroplasty","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86704","name":"Hep b core antibody total","description":"Hepatitis b core antibody (hbcab); total","date_of_service":"2026-06-05","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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27307","name":"Incision of thigh tendons","description":"Tenotomy, percutaneous, adductor or hamstring; multiple tendons","date_of_service":"2026-06-05","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":"52300","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-05","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":"82803","name":"Blood gases any combination","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation);","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61520","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor","date_of_service":"2026-06-05","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":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","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":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-06-05","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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"11040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"77401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80103","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87482","name":"Candida dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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":"94720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G6004","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-05","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":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-06-05","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":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"33502","name":"Coronary artery correction","description":"Repair of anomalous coronary artery from pulmonary artery origin; by ligation","date_of_service":"2026-06-05","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":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44390","name":"Colonoscopy for foreign body","description":"Colonoscopy through stoma; with removal of foreign body(s)","date_of_service":"2026-06-05","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":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27220","name":"Treat hip socket fracture","description":"Closed treatment of acetabulum (hip socket) fracture(s); without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-05","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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","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":"54308","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm","date_of_service":"2026-06-05","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":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-06-05","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":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-06-05","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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-05","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":"66020","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); air or liquid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-06-05","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":"23620","name":"Cltx gr hmrl tbrs fx wo mnpj","description":"Closed treatment of greater humeral tuberosity fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"58563","name":"Hysteroscopy ablation","description":"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","date_of_service":"2026-06-05","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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84120","name":"Assay of urine porphyrins","description":"Porphyrins, urine; quantitation and fractionation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57283","name":"Colpopexy intraperitoneal","description":"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-05","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":"78464","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-06-05","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":"27370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-06-05","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":"86890","name":"Autologous blood process","description":"Autologous blood or component, collection processing and storage; predeposited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45190","name":"Destruction rectal tumor","description":"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0501T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-06-05","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":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"37250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"27079","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6008","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27715","name":"Ostpl tibfib lngth/shrt","description":"Osteoplasty, tibia and fibula, lengthening or shortening","date_of_service":"2026-06-05","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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33925","name":"Rpr pul art unifocal w/o cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-06-05","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":"30420","name":"Reconstruction of nose","description":"Rhinoplasty, primary; including major septal repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27356","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with allograft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"29445","name":"Appl rigid tot cntc leg cast","description":"Application of rigid total contact leg cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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":"15361","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-05","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":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-05","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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35458","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64410","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"96406","name":"Chemo intralesional over 7","description":"Chemotherapy administration; intralesional, more than 7 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"41828","name":"Excision of gum lesion","description":"Excision of hyperplastic alveolar mucosa, each quadrant (specify)","date_of_service":"2026-06-05","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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-05","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":"82696","name":"Assay of etiocholanolone","description":"Etiocholanolone","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-05","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":"55600","name":"Vesiculotomy","description":"Vesiculotomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-05","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":"33236","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-06-05","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":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-06-05","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":"50700","name":"Revision of ureter","description":"Ureteroplasty, plastic operation on ureter (eg, stricture)","date_of_service":"2026-06-05","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":"67801","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, same lid","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","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":"48105","name":"Resect/debride pancreas","description":"Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0236T","name":"Trluml perip athrc abd aorta","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; abdominal aorta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-06-05","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":"49180","name":"Biopsy abdominal mass","description":"Biopsy, abdominal or retroperitoneal mass, percutaneous needle","date_of_service":"2026-06-05","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":"33471","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-06-05","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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-06-05","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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32552","name":"Remove lung catheter","description":"Removal of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-06-05","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":"49900","name":"Repair of abdominal wall","description":"Suture, secondary, of abdominal wall for evisceration or dehiscence","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","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":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-05","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":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-06-05","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":"65272","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9502","name":"Tc99m tetrofosmin","description":"Technetium tc-99m tetrofosmin, diagnostic, per study dose","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80157","name":"Assay carbamazepine free","description":"Carbamazepine; free","date_of_service":"2026-06-05","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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"65800","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-06-05","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":"E0240","name":"Bath/shower chair","description":"Bath/shower chair, with or without wheels, any size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0278T","name":"Tempr","description":"Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58280","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L3206","name":"Hightop w/ supp/pronator chi","description":"Orthopedic shoe, hightop with supinator or pronator, child","date_of_service":"2026-06-05","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":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82107","name":"Alpha-fetoprotein l3","description":"Alpha-fetoprotein (afp); afp-l3 fraction isoform and total afp (including ratio)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-06-05","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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G6005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8685","name":"Implt nrostm pls gen sng rec","description":"Implantable neurostimulator pulse generator, single array, rechargeable, includes extension","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66130","name":"Remove eye lesion","description":"Excision of lesion, sclera","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15340","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7510","name":"Prosthetic device repair rep","description":"Repair of prosthetic device, repair or replace minor parts","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"A6200","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99337","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-06-05","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":"23222","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"43400","name":"Ligate esophagus veins","description":"Ligation, direct, esophageal varices","date_of_service":"2026-06-05","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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47801","name":"Placement bile duct support","description":"Placement of choledochal stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-06-05","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":"35494","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-06-05","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":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0603","name":"Electric breast pump","description":"Breast pump, electric (ac and/or dc), any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32554","name":"Aspirate pleura w/o imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance","date_of_service":"2026-06-05","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":"97002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"23450","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; putti-platt procedure or magnuson type operation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-05","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":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP03","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27532","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-06-05","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":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"55680","name":"Remove sperm pouch lesion","description":"Excision of mullerian duct cyst","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-05","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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"33120","name":"Exc icar tum resc w/card byp","description":"Excision of intracardiac tumor, resection with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-06-05","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":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84138","name":"Assay of pregnanetriol","description":"Pregnanetriol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86901","name":"Blood typing serologic rh(d)","description":"Blood typing, serologic; rh (d)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-06-05","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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-05","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-06-05","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":"92325","name":"Modification of contact lens","description":"Modification of contact lens (separate procedure), with medical supervision of adaptation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27886","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-05","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":"86903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58553","name":"Laparo-vag hyst complex","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-06-05","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":"A4520","name":"Incontinence garment anytype","description":"Incontinence garment, any type, (e.g., brief, diaper), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53850","name":"Prostatic microwave thermotx","description":"Transurethral destruction of prostate tissue; by microwave thermotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-06-05","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":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-05","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":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-06-05","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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61545","name":"Excision of brain tumor","description":"Craniotomy with elevation of bone flap; for excision of craniopharyngioma","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-06-05","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41135","name":"Tongue and neck surgery","description":"Glossectomy; partial, with unilateral radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22521","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-06-05","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":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60280","name":"Remove thyroid duct lesion","description":"Excision of thyroglossal duct cyst or sinus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-05","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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21725","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; with cast application","date_of_service":"2026-06-05","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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"CPT","billing_code_type_version":"2026","billing_code":"54800","name":"Biopsy of epididymis","description":"Biopsy of epididymis, needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"99224","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A6201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21110","name":"Interdental fixation","description":"Application of interdental fixation device for conditions other than fracture or dislocation, includes removal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92340","name":"Fit spectacles monofocal","description":"Fitting of spectacles, except for aphakia; monofocal","date_of_service":"2026-06-05","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":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-05","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":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87481","name":"Candida dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-06-05","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":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44144","name":"Partial removal of colon","description":"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"62272","name":"Ther spi pnxr drg csf","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"99174","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report","date_of_service":"2026-06-05","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15301","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"21010","name":"Incision of jaw joint","description":"Arthrotomy, temporomandibular joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82016","name":"Acylcarnitines qual","description":"Acylcarnitines; qualitative, each specimen","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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":"35304","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery","date_of_service":"2026-06-05","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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-06-05","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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-06-05","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":"36591","name":"Draw blood off venous device","description":"Collection of blood specimen from a completely implantable venous access device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35485","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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":"21079","name":"Impres&prep intrm obt prosth","description":"Impression and custom preparation; interim obturator prosthesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45520","name":"Treatment of rectal prolapse","description":"Perirectal injection of sclerosing solution for prolapse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86486","name":"Skin test unlisted antign ea","description":"Skin test; unlisted antigen, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32556","name":"Insert cath pleura w/o image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47554","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with removal of calculus/calculi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89105","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-05","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":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69150","name":"Extensive ear canal surgery","description":"Radical excision external auditory canal lesion; without neck dissection","date_of_service":"2026-06-05","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":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"78587","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"82157","name":"Assay of androstenedione","description":"Androstenedione","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0145T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-05","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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-06-05","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":"28530","name":"Treat sesamoid bone fracture","description":"Closed treatment of sesamoid fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"22600","name":"Arthrd pst tq 1ntrspc crv","description":"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below c2 segment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28022","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"96111","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8505","name":"Artificial larynx, accessory","description":"Artificial larynx replacement battery / accessory, any type","date_of_service":"2026-06-05","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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83908","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27635","name":"Remove lower leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"CPT","billing_code_type_version":"2026","billing_code":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-06-05","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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":"E0246","name":"Transfer tub rail attachment","description":"Transfer tub rail attachment","date_of_service":"2026-06-05","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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"46604","name":"Anoscopy and dilation","description":"Anoscopy; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52204","name":"Cystoscopy w/biopsy(s)","description":"Cystourethroscopy, with biopsy(s)","date_of_service":"2026-06-05","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":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-06-05","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":"99363","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92571","name":"Filtered speech test","description":"Filtered speech test","date_of_service":"2026-06-05","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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78594","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29583","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35483","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44100","name":"Biopsy of bowel","description":"Biopsy of intestine by capsule, tube, peroral (1 or more specimens)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15941","name":"Exc isch pr ulc prm sut ostc","description":"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-06-05","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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-05","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":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-06-05","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":"33916","name":"Surgery of great vessel","description":"Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80201","name":"Assay of topiramate","description":"Topiramate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64712","name":"Revision of sciatic nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"29860","name":"Hip arthroscopy dx","description":"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98943","name":"Chiropract manj xtrspinl 1/>","description":"Chiropractic manipulative treatment (cmt); extraspinal, 1 or more regions","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82379","name":"Assay of carnitine","description":"Carnitine (total and free), quantitative, each specimen","date_of_service":"2026-06-05","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":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92547","name":"Supplemental electrical test","description":"Use of vertical electrodes (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"33273","name":"Repos prev impltbl subq dfb","description":"Repositioning of previously implanted subcutaneous implantable defibrillator electrode","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15750","name":"Neurovascular pedicle flap","description":"Flap; neurovascular pedicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28415","name":"Optx calcaneal fracture","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83913","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-05","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":"36819","name":"Av fuse uppr arm basilic","description":"Arteriovenous anastomosis, open; by upper arm basilic vein transposition","date_of_service":"2026-06-05","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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15792","name":"Chem peel nonfacial epidrm","description":"Chemical peel, nonfacial; epidermal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"47505","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33254","name":"Ablate atria lmtd","description":"Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure)","date_of_service":"2026-06-05","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":"L3160","name":"Shoe styled positioning dev","description":"Foot, adjustable shoe-styled positioning device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"63198","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","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":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"33213","name":"Insert pulse gen dual leads","description":"Insertion of pacemaker pulse generator only; with existing dual leads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","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":"33474","name":"Revision of pulmonary valve","description":"Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62355","name":"Remove spinal canal catheter","description":"Removal of previously implanted intrathecal or epidural catheter","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","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":"CPT","billing_code_type_version":"2026","billing_code":"43280","name":"Laparoscopy fundoplasty","description":"Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"54438","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35538","name":"Art byp grft aortobi-iliac","description":"Bypass graft, with vein; aortobi-iliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29584","name":"Appl mltlay cmprn sys up arm","description":"Application of multi-layer compression system; upper arm, forearm, hand, and fingers","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-06-05","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":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78588","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-06-05","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":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-06-05","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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-06-05","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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90880","name":"Hypnotherapy","description":"Hypnotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27882","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula; open, circular (guillotine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24220","name":"Injection px for elbow arthg","description":"Injection procedure for elbow arthrography","date_of_service":"2026-06-05","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26145","name":"Tendon excision palm/finger","description":"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15171","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26862","name":"Fusion/graft of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62355","name":"Remove spinal canal catheter","description":"Removal of previously implanted intrathecal or epidural catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83937","name":"Assay of osteocalcin","description":"Osteocalcin (bone g1a protein)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-06-05","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19355","name":"Correct inverted nipple(s)","description":"Correction of inverted nipples","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29848","name":"Wrist endoscopy/surgery","description":"Endoscopy, wrist, surgical, with release of transverse carpal ligament","date_of_service":"2026-06-05","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":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-06-05","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":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-06-05","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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25240","name":"Partial removal of ulna","description":"Excision distal ulna partial or complete (eg, darrach type or matched resection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-06-05","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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-06-05","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":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-06-05","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":"43234","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45171","name":"Exc rect tum transanal part","description":"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-06-05","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":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-05","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":"C1788","name":"Port, indwelling, imp","description":"Port, indwelling (implantable)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61795","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-06-05","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":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88107","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21401","name":"Closed tx orbit w/manipulj","description":"Closed treatment of fracture of orbit, except blowout; with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-06-05","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-06-05","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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61501","name":"Craniectomy f/osteomyelitis","description":"Craniectomy; for osteomyelitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75671","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44620","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23120","name":"Claviculectomy partial","description":"Claviculectomy; partial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-06-05","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":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"49566","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4532","name":"Ped size pull-on lg","description":"Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4930","name":"Sterile, gloves per pair","description":"Gloves, sterile, per pair","date_of_service":"2026-06-05","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"50020","name":"Drg perirnl/renal absc open","description":"Drainage of perirenal or renal abscess, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77411","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4570","name":"Splint","description":"Splint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-06-05","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":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95951","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","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":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85280","name":"Clot factor xii hageman","description":"Clotting; factor xii (hageman)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99186","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-05","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":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21400","name":"Closed tx orbit w/o manipulj","description":"Closed treatment of fracture of orbit, except blowout; without manipulation","date_of_service":"2026-06-05","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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-05","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":"85301","name":"Antithrombin iii antigen","description":"Clotting inhibitors or anticoagulants; antithrombin iii, antigen assay","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83615","name":"Lactate (ld) (ldh) enzyme","description":"Lactate dehydrogenase (ld), (ldh);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21720","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; without cast application","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-06-05","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":"25442","name":"Arthrp w/prostc dstl ulna","description":"Arthroplasty with prosthetic replacement; distal ulna","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89049","name":"Chct for mal hyperthermia","description":"Caffeine halothane contracture test (chct) for malignant hyperthermia susceptibility, including interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-06-05","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":"92020","name":"Gonioscopy","description":"Gonioscopy (separate procedure)","date_of_service":"2026-06-05","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":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"14000","name":"Tis trnfr trunk 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27625","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-06-05","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":"96102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88738","name":"Hgb quant transcutaneous","description":"Hemoglobin (hgb), quantitative, transcutaneous","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"81190","name":"Cstb gene known famil vrnt","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; known familial variant(s)","date_of_service":"2026-06-05","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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"42831","name":"Removal of adenoids","description":"Adenoidectomy, primary; age 12 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-05","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":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"97004","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-06-05","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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-06-05","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":"A4714","name":"Treated water per gallon","description":"Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"M0247","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"15826","name":"Rhytidectomy glblr frn lines","description":"Rhytidectomy; glabellar frown lines","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"96003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59076","name":"Fetal shunt placement w/us","description":"Fetal shunt placement, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"83993","name":"Assay for calprotectin fecal","description":"Calprotectin, fecal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"78460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62365","name":"Remove spine infusion device","description":"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25301","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; extensors of fingers","date_of_service":"2026-06-05","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":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-06-05","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49570","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-06-05","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":"67255","name":"Reinforce/graft eye wall","description":"Scleral reinforcement (separate procedure); with graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-06-05","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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75992","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27230","name":"Treat thigh fracture","description":"Closed treatment of femoral fracture, proximal end, neck; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"31656","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58260","name":"Vaginal hysterectomy","description":"Vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-06-05","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":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-06-05","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":"L8688","name":"Implt nrostm pls gen dua non","description":"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension","date_of_service":"2026-06-05","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":"Q4097","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0296T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33465","name":"Replace tricuspid valve","description":"Replacement, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"T4538","name":"Diaper serv reusable diaper","description":"Diaper service, reusable diaper, each diaper","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-06-05","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":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56630","name":"Vulvectomy radical partial","description":"Vulvectomy, radical, partial;","date_of_service":"2026-06-05","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":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85540","name":"Wbc alkaline phosphatase","description":"Leukocyte alkaline phosphatase with count","date_of_service":"2026-06-05","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":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-05","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":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"55700","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","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":"65436","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with application of chelating agent (eg, edta)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"60505","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"89141","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-06-05","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":"33235","name":"Removal pacemaker electrode","description":"Removal of transvenous pacemaker electrode(s); dual lead system","date_of_service":"2026-06-05","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":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82633","name":"Desoxycorticosterone","description":"Desoxycorticosterone, 11-","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"31572","name":"Largsc w/laser dstrj les","description":"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral","date_of_service":"2026-06-05","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35650","name":"Bpg axillary-axillary","description":"Bypass graft, with other than vein; axillary-axillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-06-05","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":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","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":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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":"63610","name":"Stimulation of spinal cord","description":"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A9555","name":"Rb82 rubidium","description":"Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24495","name":"Decompression fasct forearm","description":"Decompression fasciotomy, forearm, with brachial artery exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27347","name":"Remove knee cyst","description":"Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23655","name":"Cltx sho dslc w/mnpj w/anes","description":"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"96120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-05","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"54164","name":"Frenulotomy of penis","description":"Frenulotomy of penis","date_of_service":"2026-06-05","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":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-06-05","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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58740","name":"Adhesiolysis tube ovary","description":"Lysis of adhesions (salpingolysis, ovariolysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23120","name":"Claviculectomy partial","description":"Claviculectomy; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-06-05","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":"66505","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"89322","name":"Semen anal strict criteria","description":"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, kruger)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-05","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":"32669","name":"Thoracoscopy remove segment","description":"Thoracoscopy, surgical; with removal of a single lung segment (segmentectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-06-05","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":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6025","name":"Silicone gel sheet, each","description":"Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each","date_of_service":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-05","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-06-05","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":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"90822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36834","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32906","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages); with closure of bronchopleural fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52332","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-06-05","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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64570","name":"Remove vagus n eltrd","description":"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33702","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99186","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28234","name":"Incision of foot tendon","description":"Tenotomy, open, extensor, foot or toe, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92591","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95936","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55700","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75650","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-05","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":"47380","name":"Open ablate liver tumor rf","description":"Ablation, open, of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76498","name":"Unlisted mr procedure","description":"Unlisted magnetic resonance procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-05","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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-06-05","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":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"91303","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33254","name":"Ablate atria lmtd","description":"Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27403","name":"Repair of knee cartilage","description":"Arthrotomy with meniscus repair, knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75961","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-06-05","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":"37229","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-06-05","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":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-05","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0307","name":"Cbc without platelet","description":"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)","date_of_service":"2026-06-05","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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"38790","name":"Inject for lymphatic x-ray","description":"Injection procedure; lymphangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"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":"43458","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"49605","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with or without prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42300","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-05","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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-05","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":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-06-05","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":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3212","name":"Benesch boot pair infant","description":"Benesch boot, pair, infant","date_of_service":"2026-06-05","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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"36589","name":"Removal tunneled cv cath","description":"Removal of tunneled central venous catheter, without subcutaneous port or pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64614","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28160","name":"Partial removal of toe","description":"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26525","name":"Release finger contracture","description":"Capsulectomy or capsulotomy; interphalangeal joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86155","name":"Chemotaxis assay","description":"Chemotaxis assay, specify method","date_of_service":"2026-06-05","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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27486","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; 1 component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67227","name":"Dstrj extensive retinopathy","description":"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31090","name":"Exploration of sinuses","description":"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)","date_of_service":"2026-06-05","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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-05","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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","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":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-06-05","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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85302","name":"Clot inhibit prot c antigen","description":"Clotting inhibitors or anticoagulants; protein c, antigen","date_of_service":"2026-06-05","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":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-05","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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71060","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-06-05","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":"99220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23125","name":"Claviculectomy total","description":"Claviculectomy; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-05","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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-06-05","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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28200","name":"Repair of foot tendon","description":"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"50686","name":"Measure ureter pressure","description":"Manometric studies through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-05","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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-06-05","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":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-06-05","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":"87272","name":"Cryptosporidium ag if","description":"Infectious agent antigen detection by immunofluorescent technique; cryptosporidium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4266","name":"Diaphragm","description":"Diaphragm for contraceptive use","date_of_service":"2026-06-05","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":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-06-05","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":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27437","name":"Revise kneecap","description":"Arthroplasty, patella; without prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"36516","name":"Apheresis immunoads slctv","description":"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion","date_of_service":"2026-06-05","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":"58976","name":"Transfer of embryo","description":"Gamete, zygote, or embryo intrafallopian transfer, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"96155","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43842","name":"Gstr rstcv px v-banded gstp","description":"Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical-banded gastroplasty","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61501","name":"Craniectomy f/osteomyelitis","description":"Craniectomy; for osteomyelitis","date_of_service":"2026-06-05","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"40804","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45171","name":"Exc rect tum transanal part","description":"Excision of rectal tumor, transanal approach; not including muscularis propria (ie, partial thickness)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49587","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3652","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","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":"33412","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with transventricular aortic annulus enlargement (konno procedure)","date_of_service":"2026-06-05","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":"64835","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; median motor thenar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27326","name":"Neurectomy popliteal","description":"Neurectomy, popliteal (gastrocnemius)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86713","name":"Legionella antibody","description":"Antibody; legionella","date_of_service":"2026-06-05","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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28715","name":"Arthrodesis triple","description":"Arthrodesis; triple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36660","name":"Insertion catheter artery","description":"Catheterization, umbilical artery, newborn, for diagnosis or therapy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"22520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-05","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":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-06-05","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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32220","name":"Release of lung","description":"Decortication, pulmonary (separate procedure); total","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19316","name":"Mastopexy","description":"Mastopexy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-06-05","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":"82552","name":"Assay of cpk in blood","description":"Creatine kinase (ck), (cpk); isoenzymes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25420","name":"Repair/graft radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95832","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82308","name":"Assay of calcitonin","description":"Calcitonin","date_of_service":"2026-06-05","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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-06-05","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":"40819","name":"Excise lip or cheek fold","description":"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-05","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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15836","name":"Exc excessive skin arm","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-06-05","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":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29875","name":"Arthrs knee surg synvct lmtd","description":"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)","date_of_service":"2026-06-05","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":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76102","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"65103","name":"Remove eye/insert implant","description":"Enucleation of eye; with implant, muscles not attached to implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56632","name":"Vlvctmy rad prtl bi lymphad","description":"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64840","name":"Repair of leg nerve","description":"Suture of posterior tibial nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31030","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) without removal of antrochoanal polyps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"25112","name":"Reremove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); recurrent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"11041","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28306","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal","date_of_service":"2026-06-05","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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35266","name":"Rpr blvsl grf oth/th vn uxtr","description":"Repair blood vessel with graft other than vein; upper extremity","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-06-05","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":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21925","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; deep","date_of_service":"2026-06-05","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":"15176","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31293","name":"Nsl/sins ndsc med&inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial and inferior wall","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-06-05","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":"46285","name":"Remove anal fist 2 stage","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4730","name":"Fistula cannulation set, ea","description":"Fistula cannulation set for hemodialysis, each","date_of_service":"2026-06-05","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30124","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; simple, skin, subcutaneous","date_of_service":"2026-06-05","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":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93545","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44970","name":"Laparoscopy appendectomy","description":"Laparoscopy, surgical, appendectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27676","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; with fibular osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84207","name":"Assay of vitamin b-6","description":"Pyridoxal phosphate (vitamin b-6)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","other_properties":[{"name":"FacilityZip","value":["10509","10512","10516","10524","10537","10541","10542","10579","10910","10912","10914","10915","10916","10917","10918","10919","10921","10922","10924","10925","10926","10928","10930","10932","10933","10940","10941","10943","10949","10950","10953","10958","10959","10963","10969","10973","10975","10979","10981","10985","10987","10988","10990","10992","10996","10997","10998","12015","12017","12029","12037","12042","12050","12051","12058","12060","12075","12083","12087","12106","12115","12124","12125","12130","12132","12136","12165","12167","12172","12173","12174","12176","12184","12192","12195","12401","12402","12404","12405","12406","12407","12409","12410","12411","12412","12413","12414","12416","12417","12418","12419","12420","12421","12422","12423","12424","12427","12428","12429","12430","12431","12432","12433","12434","12435","12436","12438","12439","12440","12441","12442","12443","12444","12446","12448","12449","12450","12451","12452","12453","12454","12455","12456","12457","12458","12459","12460","12461","12463","12464","12465","12466","12468","12470","12471","12472","12473","12474","12475","12477","12480","12481","12482","12483","12484","12485","12486","12487","12489","12490","12491","12492","12493","12494","12495","12496","12498","12501","12502","12503","12504","12506","12507","12508","12510","12511","12512","12513","12514","12515","12516","12517","12518","12520","12521","12522","12523","12524","12525","12526","12527","12528","12529","12530","12531","12533","12534","12537","12538","12540","12541","12542","12543","12544","12545","12546","12547","12548","12549","12550","12551","12552","12553","12555","12561","12563","12564","12565","12566","12567","12568","12569","12570","12571","12572","12574","12575","12577","12578","12580","12581","12582","12583","12584","12585","12586","12588","12589","12590","12592","12593","12594","12601","12602","12603","12604","12701","12719","12720","12721","12722","12723","12724","12725","12726","12727","12729","12732","12733","12734","12736","12737","12738","12740","12741","12742","12743","12745","12746","12747","12748","12749","12750","12751","12752","12754","12758","12759","12760","12762","12763","12764","12765","12766","12767","12768","12769","12770","12771","12775","12776","12777","12778","12779","12780","12781","12782","12783","12784","12785","12786","12787","12788","12789","12790","12791","12792","13731","13739","13740","13750","13751","13752","13753","13755","13756","13757","13774","13775","13782","13783","13786","13788","13804","13806","13837","13838","13839","13842","13846","13847","13856","13860"]}],"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"]}],"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"]}],"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"]}],"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"]}],"provider_references":[4]},{"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"]}],"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"]}],"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"]}],"provider_references":[6]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43850","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43320","name":"Fuse esophagus & stomach","description":"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach","date_of_service":"2026-06-05","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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25360","name":"Revision of ulna","description":"Osteotomy; ulna","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-06-05","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":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-05","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":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0244","name":"Toilet seat raised","description":"Raised toilet seat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-06-05","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":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"62201","name":"Brain cavity shunt w/scope","description":"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75665","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"90822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49423","name":"Exchange drainage catheter","description":"Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31786","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; thoracic","date_of_service":"2026-06-05","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":"43610","name":"Excision of stomach lesion","description":"Excision, local; ulcer or benign tumor of stomach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27301","name":"Drain thigh/knee lesion","description":"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-05","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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-05","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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"66630","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27516","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83901","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69155","name":"Extensive ear/neck surgery","description":"Radical excision external auditory canal lesion; with neck dissection","date_of_service":"2026-06-05","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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-06-05","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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94668","name":"Mnpj chest wall sbsq","description":"Manipulation chest wall, such as cupping, percussing, and vibration to facilitate lung function; subsequent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41100","name":"Biopsy of tongue","description":"Biopsy of tongue; anterior two-thirds","date_of_service":"2026-06-05","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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-05","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":"G0392","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4380","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47350","name":"Repair liver wound","description":"Management of liver hemorrhage; simple suture of liver wound or injury","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-06-05","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":"82953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31201","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62005","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; compound or comminuted, extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-06-05","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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21339","name":"Open nasoethmoid fx w/ fixj","description":"Open treatment of nasoethmoid fracture; with external fixation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"S3835","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"60200","name":"Remove thyroid lesion","description":"Excision of cyst or adenoma of thyroid, or transection of isthmus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23520","name":"Cltx strnclav dislc w/o mnpj","description":"Closed treatment of sternoclavicular dislocation; without manipulation","date_of_service":"2026-06-05","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":"G2023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26740","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; without manipulation, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-05","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":"77406","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"84681","name":"Assay of c-peptide","description":"C-peptide","date_of_service":"2026-06-05","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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28054","name":"Biopsy of toe joint lining","description":"Arthrotomy with biopsy; interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27176","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ","date_of_service":"2026-06-05","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":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28192","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; deep","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51720","name":"Treatment of bladder lesion","description":"Bladder instillation of anticarcinogenic agent (including retention time)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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 e","date_of_service":"2026-06-05","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":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90468","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"83890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-06-05","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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-05","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":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36834","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65860","name":"Severing ads ant sgm laser","description":"Severing adhesions of anterior segment, laser technique (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41512","name":"Tongue suspension","description":"Tongue base suspension, permanent suture technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"96440","name":"Chmotx admn plrl cav thrcnts","description":"Chemotherapy administration into pleural cavity, requiring and including thoracentesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35456","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90857","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27269","name":"Optx thigh fx","description":"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26607","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-06-05","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":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86692","name":"Hepatitis delta agent antbdy","description":"Antibody; hepatitis, delta agent","date_of_service":"2026-06-05","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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-06-05","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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-06-05","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":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L0210","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27409","name":"Repair of knee ligaments","description":"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"56442","name":"Hymenotomy","description":"Hymenotomy, simple incision","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90829","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-05","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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-06-05","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":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29836","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78586","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88154","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31400","name":"Revision of larynx","description":"Arytenoidectomy or arytenoidopexy, external approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-05","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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-06-05","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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"40805","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; complicated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28022","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"68750","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with insertion of tube or stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19342","name":"Insj/rplcmt brst implt sep d","description":"Insertion or replacement of breast implant on separate day from mastectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-06-05","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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"48548","name":"Fuse pancreas and bowel","description":"Pancreaticojejunostomy, side-to-side anastomosis (puestow-type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84238","name":"Assay nonendocrine receptor","description":"Receptor assay; non-endocrine (specify receptor)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68360","name":"Revise eyelid lining","description":"Conjunctival flap; bridge or partial (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-06-05","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":"33536","name":"Cabg arterial four or more","description":"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32601","name":"Thoracoscopy diagnostic","description":"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43502","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, mallory-weiss)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-06-05","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":"61795","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80172","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"80158","name":"Drug assay cyclosporine","description":"Cyclosporine","date_of_service":"2026-06-05","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":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93875","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35647","name":"Bpg aortofemoral","description":"Bypass graft, with other than vein; aortofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"M0239","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"19101","name":"Biopsy of breast open","description":"Biopsy of breast; open, incisional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42205","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4104","name":"Additive for enteral formula","description":"Additive for enteral formula (e.g., fiber)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69000","name":"Drg xtrnl ear absc/hem smpl","description":"Drainage external ear, abscess or hematoma; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19110","name":"Nipple exploration","description":"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-06-05","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":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9537","name":"Tc99m mebrofenin","description":"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"41115","name":"Excision of tongue fold","description":"Excision of lingual frenum (frenectomy)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","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":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"28112","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; other metatarsal head (second, third or fourth)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-06-05","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":"20527","name":"Njx nzm palmar fascial cord","description":"Injection, enzyme (eg, collagenase), palmar fascial cord (ie, dupuytrens contracture)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27468","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33504","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29515","name":"Application short leg splint","description":"Application of short leg splint (calf to foot)","date_of_service":"2026-06-05","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":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92071","name":"Contact lens fitting for tx","description":"Fitting of contact lens for treatment of ocular surface disease","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-05","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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-05","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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-05","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":"47570","name":"Laparo cholecystoenterostomy","description":"Laparoscopy, surgical; cholecystoenterostomy","date_of_service":"2026-06-05","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":"L1901","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-05","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-06-05","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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15824","name":"Rhytidectomy forehead","description":"Rhytidectomy; forehead","date_of_service":"2026-06-05","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":"43265","name":"Ercp lithotripsy calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24577","name":"Cltx humrl cndylr fx w/mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93528","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75940","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-05","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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-06-05","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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33363","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open axillary artery approach","date_of_service":"2026-06-05","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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-05","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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"L7261","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-06-05","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":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"19364","name":"Brst rcnstj free flap","description":"Breast reconstruction; with free flap (eg, ftram, diep, siea, gap flap)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64911","name":"Neurorraphy w/vein autograft","description":"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"65778","name":"Cover eye w/membrane","description":"Placement of amniotic membrane on the ocular surface; without sutures","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"92591","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","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":["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":"2026-06-05","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":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80182","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-06-05","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":"66505","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20979","name":"Lw ntsty us stimj bone healg","description":"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35363","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"89230","name":"Collect sweat for test","description":"Sweat collection by iontophoresis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G2063","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3216","name":"Orthoped ladies shoes dpth i","description":"Orthopedic footwear, ladies shoe, depth inlay, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82365","name":"Calculus spectroscopy","description":"Calculus; infrared spectroscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43810","name":"Gastroduodenostomy","description":"Gastroduodenostomy","date_of_service":"2026-06-05","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":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"87450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"G6015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-06-05","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":"90476","name":"Adenovirus vaccine type 4","description":"Adenovirus vaccine, type 4, live, for oral use","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3211","name":"Surgical boot each junior","description":"Surgical boot, each, junior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68540","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; frontal approach","date_of_service":"2026-06-05","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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83937","name":"Assay of osteocalcin","description":"Osteocalcin (bone g1a protein)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"33430","name":"Replacement of mitral valve","description":"Replacement, mitral valve, with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25929","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; secondary closure or scar revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","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":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-06-05","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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28011","name":"Incision of toe tendons","description":"Tenotomy, percutaneous, toe; multiple tendons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11752","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27246","name":"Treat thigh fracture","description":"Closed treatment of greater trochanteric fracture, without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82938","name":"Gastrin test","description":"Gastrin after secretin stimulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86941","name":"Hemolysins/agglutinins","description":"Hemolysins and agglutinins; incubated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-06-05","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":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33534","name":"Cabg arterial two","description":"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts","date_of_service":"2026-06-05","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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-05","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":"86644","name":"Cmv antibody","description":"Antibody; cytomegalovirus (cmv)","date_of_service":"2026-06-05","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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26261","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75564","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50205","name":"Renal bx surg exposure kdn","description":"Renal biopsy; by surgical exposure of kidney","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"81020","name":"Urinalysis glass test","description":"Urinalysis; 2 or 3 glass test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50392","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-06-05","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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-06-05","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":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-06-05","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":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"35650","name":"Bpg axillary-axillary","description":"Bypass graft, with other than vein; axillary-axillary","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"34826","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-05","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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","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":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26479","name":"Shortening of hand tendon","description":"Shortening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-06-05","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":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33861","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93720","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-06-05","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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","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":"27768","name":"Cltx post ankle fx w/mnpj","description":"Closed treatment of posterior malleolus fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"29355","name":"Appl long leg cast walker","description":"Application of long leg cast (thigh to toes); walker or ambulatory type","date_of_service":"2026-06-05","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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-06-05","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":"27403","name":"Repair of knee cartilage","description":"Arthrotomy with meniscus repair, knee","date_of_service":"2026-06-05","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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76496","name":"Unlisted fluoroscopic px","description":"Unlisted fluoroscopic procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-06-05","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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-06-05","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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-06-05","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":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-06-05","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":"57270","name":"Repair of bowel pouch","description":"Repair of enterocele, abdominal approach (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-06-05","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92579","name":"Visual audiometry (vra)","description":"Visual reinforcement audiometry (vra)","date_of_service":"2026-06-05","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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3208","name":"Surgical boot each infant","description":"Surgical boot, each, infant","date_of_service":"2026-06-05","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":"33050","name":"Resect heart sac lesion","description":"Resection of pericardial cyst or tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-06-05","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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-05","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":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83499","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85293","name":"Clot factor wght kininogen","description":"Clotting; high molecular weight kininogen assay (fitzgerald factor assay)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-05","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":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-05","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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-06-05","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":"53852","name":"Prostatic rf thermotx","description":"Transurethral destruction of prostate tissue; by radiofrequency thermotherapy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","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":"80182","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"60220","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-06-05","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":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-06-05","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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-06-05","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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"15361","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83662","name":"Foam stability fetal lung","description":"Fetal lung maturity assessment; foam stability test","date_of_service":"2026-06-05","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":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96155","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84078","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline; heat stable (total not included)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"46762","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"87557","name":"M.tuberculo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4301","name":"Implantable access syst perc","description":"Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-06-05","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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54105","name":"Biopsy of penis","description":"Biopsy of penis; deep structures","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"01632","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4458","name":"Reusable enema bag","description":"Enema bag with tubing, reusable","date_of_service":"2026-06-05","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":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23180","name":"Prtl excision bone clavicle","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-06-05","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":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-06-05","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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5363","name":"Language screening","description":"Language screening","date_of_service":"2026-06-05","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":"78594","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49653","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"24655","name":"Cltx rdl head/nck fx w/mnpj","description":"Closed treatment of radial head or neck fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35506","name":"Art byp grft subclav-carotid","description":"Bypass graft, with vein; carotid-subclavian or subclavian-carotid","date_of_service":"2026-06-05","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":"53200","name":"Biopsy of urethra","description":"Biopsy of urethra","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44314","name":"Revision of ileostomy","description":"Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50686","name":"Measure ureter pressure","description":"Manometric studies through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-06-05","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":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26432","name":"Repair finger tendon","description":"Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (eg, mallet finger)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"90811","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-05","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":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-05","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":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"99363","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35506","name":"Art byp grft subclav-carotid","description":"Bypass graft, with vein; carotid-subclavian or subclavian-carotid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"89320","name":"Semen anal vol/count/mot","description":"Semen analysis; volume, count, motility, and differential","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","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":"44135","name":"Intestine transplnt cadaver","description":"Intestinal allotransplantation; from cadaver donor","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57260","name":"Cmbn ant pst colprhy","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90467","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82646","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41520","name":"Reconstruction tongue fold","description":"Frenoplasty (surgical revision of frenum, eg, with z-plasty)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64505","name":"N block spenopalatine gangl","description":"Injection, anesthetic agent; sphenopalatine ganglion","date_of_service":"2026-06-05","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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-06-05","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":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69805","name":"Explore inner ear","description":"Endolymphatic sac operation; without shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-06-05","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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-06-05","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":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"53040","name":"Drainage of urethra abscess","description":"Drainage of deep periurethral abscess","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4465","name":"Non-elastic extremity binder","description":"Non-elastic binder for extremity","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27871","name":"Fusion of tibiofibular joint","description":"Arthrodesis, tibiofibular joint, proximal or distal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"15951","name":"Exc trchntr pr ulc ostc","description":"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25215","name":"Removal of wrist bones","description":"Carpectomy; all bones of proximal row","date_of_service":"2026-06-05","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":"87809","name":"Adenovirus assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; adenovirus","date_of_service":"2026-06-05","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":"83887","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-05","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":"23490","name":"Reinforce clavicle","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle","date_of_service":"2026-06-05","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":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25447","name":"Arthrp ntrcrp/crp/mtcr ntrps","description":"Arthroplasty, intercarpal or carpometacarpal joints; interposition (eg, tendon)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3911","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-06-05","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93528","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21700","name":"Revision of neck muscle","description":"Division of scalenus anticus; without resection of cervical rib","date_of_service":"2026-06-05","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":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-05","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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-05","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":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"22851","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"41140","name":"Removal of tongue","description":"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection","date_of_service":"2026-06-05","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":"36870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"88329","name":"Path consltj drg surg","description":"Pathology consultation during surgery;","date_of_service":"2026-06-05","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":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-05","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":"78465","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27194","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-05","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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0103","name":"Psa screening","description":"Prostate cancer screening; prostate specific antigen test (psa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-06-05","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":"11102","name":"Tangntl bx skin single les","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-05","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-06-05","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":"90827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G2066","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"46938","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33726","name":"Repair pul venous stenosis","description":"Repair of pulmonary venous stenosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37208","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82671","name":"Assay of estrogens","description":"Estrogens; fractionated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-05","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":"54015","name":"I&d penis deep","description":"Incision and drainage of penis, deep","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35691","name":"Art trnsposj vertbrl carotid","description":"Transposition and/or reimplantation; vertebral to carotid artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"57061","name":"Destruction vag lesions smpl","description":"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"36416","name":"Collj capillary blood spec","description":"Collection of capillary blood specimen (eg, finger, heel, ear stick)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67808","name":"Remove eyelid lesion(s)","description":"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"39545","name":"Revision of diaphragm","description":"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9505","name":"Tl201 thallium","description":"Thallium tl-201 thallous chloride, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43652","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-05","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":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-06-05","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86789","name":"West nile virus antibody","description":"Antibody; west nile virus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90465","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33535","name":"Cabg arterial three","description":"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-06-05","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":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33976","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-06-05","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":"36860","name":"External cannula declotting","description":"External cannula declotting (separate procedure); without balloon catheter","date_of_service":"2026-06-05","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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6004","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-05","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"32035","name":"Thoracostomy w/rib resection","description":"Thoracostomy; with rib resection for empyema","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29860","name":"Hip arthroscopy dx","description":"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","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":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-06-05","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":"26556","name":"Toe joint transfer","description":"Transfer, free toe joint, with microvascular anastomosis","date_of_service":"2026-06-05","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":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49423","name":"Exchange drainage catheter","description":"Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)","date_of_service":"2026-06-05","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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-06-05","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":"46611","name":"Anoscopy","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86663","name":"Epstein-barr antibody","description":"Antibody; epstein-barr (eb) virus, early antigen (ea)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26437","name":"Realignment of tendons","description":"Realignment of extensor tendon, hand, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["11004","11005","11101","11102","11103","11104","11105","11106","11109","11120","11351","11352","11354","11355","11356","11357","11358","11359","11360","11361","11362","11363","11364","11365","11366","11367","11368","11369","11370","11371","11372","11373","11374","11375","11377","11378","11379","11380","11381","11385","11386","11390","11405","11411","11412","11413","11414","11415","11416","11417","11418","11419","11420","11421","11422","11423","11424","11425","11426","11427","11428","11429","11430","11431","11432","11433","11434","11435","11436","11437","11439","11451","11499","11690","11691","11692","11693","11694","11695","11697"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57265","name":"Cmbn ap colprhy w/ntrcl rpr","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0451","name":"Devlopment test interpt&rep","description":"Development testing, with interpretation and report, per standardized instrument form","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92341","name":"Fit spectacles bifocal","description":"Fitting of spectacles, except for aphakia; bifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-06-05","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":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-05","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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33366","name":"Trcath replace aortic valve","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transapical exposure (eg, left thoracotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-06-05","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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44340","name":"Revision of colostomy","description":"Revision of colostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41821","name":"Excision of gum flap","description":"Operculectomy, excision pericoronal tissues","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-06-05","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19101","name":"Biopsy of breast open","description":"Biopsy of breast; open, incisional","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42410","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35548","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83894","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90817","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP03","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45550","name":"Repair rectum/remove sigmoid","description":"Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0290T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"38222","name":"Dx bone marrow bx & aspir","description":"Diagnostic bone marrow; biopsy(ies) and aspiration(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83550","name":"Iron binding test","description":"Iron binding capacity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-06-05","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":"H0047","name":"Alcohol/drug abuse svc nos","description":"Alcohol and/or other drug abuse services, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"86891","name":"Autologous blood op salvage","description":"Autologous blood or component, collection processing and storage; intra- or postoperative salvage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0422","name":"Intens cardiac rehab w/exerc","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring with exercise, per session","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86185","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75996","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"57285","name":"Repair paravag defect vag","description":"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-05","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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26410","name":"Repair hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4500","name":"Below knee surgical stocking","description":"Surgical stockings below knee length, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66183","name":"Insert ant drainage device","description":"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50394","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-06-05","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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87265","name":"Pertussis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; bordetella pertussis/parapertussis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"36010","name":"Place catheter in vein","description":"Introduction of catheter, superior or inferior vena cava","date_of_service":"2026-06-05","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":"26025","name":"Drainage of palm bursa","description":"Drainage of palmar bursa; single, bursa","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"89132","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"32505","name":"Wedge resect of lung initial","description":"Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53410","name":"Reconstruction of urethra","description":"Urethroplasty, 1-stage reconstruction of male anterior urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-05","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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"T4528","name":"Adult size pull-on xl","description":"Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each","date_of_service":"2026-06-05","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":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-06-05","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0198T","name":"Ocular blood flow measure","description":"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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":"43501","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of bleeding ulcer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"G0451","name":"Devlopment test interpt&rep","description":"Development testing, with interpretation and report, per standardized instrument form","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27712","name":"Osteot mlt relignmt imed rod","description":"Osteotomy; multiple, with realignment on intramedullary rod (eg, sofield type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4222","name":"Parenteral supply kit homemi","description":"Parenteral nutrition supply kit; home mix, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-05","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-06-05","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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24200","name":"Rmvl fb upper arm/elbw subq","description":"Removal of foreign body, upper arm or elbow area; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-06-05","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":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-06-05","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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6576","name":"Custom grad com sleeve med","description":"Gradient  compression arm sleeve, custom, medium weight, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27658","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"67141","name":"Proph rta dtchmnt crtx dthrm","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"15366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-05","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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-06-05","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":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-05","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":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-05","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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"98942","name":"Chiropractic manj 5 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 5 regions","date_of_service":"2026-06-05","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":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-06-05","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":"29020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85598","name":"Hexagnal phosph pltlt neutrl","description":"Phospholipid neutralization; hexagonal phospholipid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41115","name":"Excision of tongue fold","description":"Excision of lingual frenum (frenectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"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":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-06-05","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":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-06-05","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":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-06-05","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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"55060","name":"Repair of hydrocele","description":"Repair of tunica vaginalis hydrocele (bottle type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29581","name":"Appl multlayer cmprn sys leg","description":"Application of multi-layer compression system; leg (below knee), including ankle and foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49080","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96445","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-05","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":"15944","name":"Exc isch pr ulc skn flp clsr","description":"Excision, ischial pressure ulcer, with skin flap closure;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33675","name":"Close mult vsd","description":"Closure of multiple ventricular septal defects;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42107","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with local flap closure","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33236","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","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":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","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":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21188","name":"Reconstruction of midface","description":"Reconstruction midface, osteotomies (other than lefort type) and bone grafts (includes obtaining autografts)","date_of_service":"2026-06-05","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":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-06-05","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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20822","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation","date_of_service":"2026-06-05","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":"33861","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"82485","name":"Assay chondroitin sulfate","description":"Chondroitin b sulfate, quantitative","date_of_service":"2026-06-05","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":"33694","name":"Cmp rpr tof wo plm atrs ptch","description":"Complete repair tetralogy of fallot without pulmonary atresia; with transannular patch","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69820","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A9552","name":"F18 fdg","description":"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50300","name":"Remove cadaver donor kidney","description":"Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63746","name":"Removal of spinal shunt","description":"Removal of entire lumbosubarachnoid shunt system without replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75992","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78807","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25109","name":"Excise tendon forearm/wrist","description":"Excision of tendon, forearm and/or wrist, flexor or extensor, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"67312","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 horizontal muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-06-05","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":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45303","name":"Proctosigmoidoscopy dilate","description":"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0034A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83550","name":"Iron binding test","description":"Iron binding capacity","date_of_service":"2026-06-05","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":"68840","name":"Explore/irrigate tear ducts","description":"Probing of lacrimal canaliculi, with or without irrigation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29835","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-05","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":"49041","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28293","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-05","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":"33286","name":"Rmvl subq car rhythm mntr","description":"Removal, subcutaneous cardiac rhythm monitor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-06-05","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":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-06-05","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":"33945","name":"Transplantation of heart","description":"Heart transplant, with or without recipient cardiectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-06-05","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":"21079","name":"Impres&prep intrm obt prosth","description":"Impression and custom preparation; interim obturator prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4652","name":"Microcapillary tube sealant","description":"Microcapillary tube sealant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33212","name":"Insert pulse gen sngl lead","description":"Insertion of pacemaker pulse generator only; with existing single lead","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64472","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-06-05","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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28737","name":"Revision of foot bones","description":"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23655","name":"Cltx sho dslc w/mnpj w/anes","description":"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia","date_of_service":"2026-06-05","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":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-06-05","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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34421","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77414","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36833","name":"Av fistula revision","description":"Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"38214","name":"Volume deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"38211","name":"Tumor cell deplete of harvst","description":"Transplant preparation of hematopoietic progenitor cells; tumor cell depletion","date_of_service":"2026-06-05","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":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-05","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33410","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44212","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77032","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S8101","name":"Spacer with mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; with mask","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-06-05","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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99251","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15829","name":"Rhytidectomy smas flap","description":"Rhytidectomy; superficial musculoaponeurotic system (smas) flap","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"32666","name":"Thoracoscopy w/wedge resect","description":"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-06-05","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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"39501","name":"Repair diaphragm laceration","description":"Repair, laceration of diaphragm, any approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-06-05","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":"69676","name":"Remove middle ear nerve","description":"Tympanic neurectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35634","name":"Bpg iliorenal","description":"Bypass graft, with other than vein; iliorenal","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-05","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":"44151","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, without proctectomy; with continent ileostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"97804","name":"Medical nutrition group","description":"Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes","date_of_service":"2026-06-05","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":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-06-05","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":"54000","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35583","name":"Vein byp grft fem-popliteal","description":"In-situ vein bypass; femoral-popliteal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"31595","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01682","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"47701","name":"Bile duct revision","description":"Portoenterostomy (eg, kasai procedure)","date_of_service":"2026-06-05","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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","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":"0440T","name":"Abltj perc uxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve","date_of_service":"2026-06-05","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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-06-05","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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43850","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-06-05","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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-05","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":"46045","name":"I&d absc tranal under anes","description":"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia","date_of_service":"2026-06-05","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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44147","name":"Partial removal of colon","description":"Colectomy, partial; abdominal and transanal approach","date_of_service":"2026-06-05","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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35473","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87542","name":"Legion pneumo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, quantification","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78594","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"00740","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31529","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"84061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90865","name":"Narcosynthesis","description":"Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium amobarbital (amytal) interview)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-05","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":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0761","name":"Nontherm electromgntc device","description":"Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35548","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84080","name":"Assay alkaline phosphatases","description":"Phosphatase, alkaline; isoenzymes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"24650","name":"Cltx rdl head/nck fx wo mnpj","description":"Closed treatment of radial head or neck fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15321","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"35266","name":"Rpr blvsl grf oth/th vn uxtr","description":"Repair blood vessel with graft other than vein; upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35188","name":"Rpr acq av fistula head&neck","description":"Repair, acquired or traumatic arteriovenous fistula; head and neck","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8460","name":"Camisole post-mast","description":"Camisole, post-mastectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-06-05","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":"86707","name":"Hepatitis be antibody","description":"Hepatitis be antibody (hbeab)","date_of_service":"2026-06-05","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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-06-05","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":"39545","name":"Revision of diaphragm","description":"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic","date_of_service":"2026-06-05","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":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-06-05","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":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90824","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-05","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":"64680","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29800","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27253","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, without internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58760","name":"Fimbrioplasty","description":"Fimbrioplasty","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95012","name":"Nitric oxide exp gas deter","description":"Nitric oxide expired gas determination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77014","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53665","name":"Dilation of urethra","description":"Dilation of female urethra, general or conduction (spinal) anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37234","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28272","name":"Release of toe joint each","description":"Capsulotomy; interphalangeal joint, each joint (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64822","name":"Sympathectomy ulnar artery","description":"Sympathectomy; ulnar artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23200","name":"Radical rescj tumor clavicle","description":"Radical resection of tumor; clavicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62220","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-atrial, -jugular, -auricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32673","name":"Thoracoscopy w/thymus resect","description":"Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56630","name":"Vulvectomy radical partial","description":"Vulvectomy, radical, partial;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"54660","name":"Revision of testis","description":"Insertion of testicular prosthesis (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"58356","name":"Endometrial cryoablation","description":"Endometrial cryoablation with ultrasonic guidance, including endometrial curettage, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69705","name":"Nps surg dilat eust tube uni","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-05","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":"78220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86632","name":"Chlamydia igm antibody","description":"Antibody; chlamydia, igm","date_of_service":"2026-06-05","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":"21077","name":"Impres&prep orbital prosth","description":"Impression and custom preparation; orbital prosthesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29710","name":"Rmvl/bivlv sho/hip spica","description":"Removal or bivalving; shoulder or hip spica, minerva, or risser jacket, etc.","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-05","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-06-05","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":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0190T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-06-05","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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0102","name":"Prostate ca screening; dre","description":"Prostate cancer screening; digital rectal examination","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28540","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia","date_of_service":"2026-06-05","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":"45305","name":"Proctosigmoidoscopy w/bx","description":"Proctosigmoidoscopy, rigid; with biopsy, single or multiple","date_of_service":"2026-06-05","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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-06-05","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78587","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"13150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2301","name":"Pwr standing","description":"Wheelchair accessory, power standing system, any type","date_of_service":"2026-06-05","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":"33617","name":"Repair single ventricle","description":"Repair of complex cardiac anomalies (eg, single ventricle) by modified fontan procedure","date_of_service":"2026-06-05","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":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-06-05","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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-05","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":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15780","name":"Dermabrasion total face","description":"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"29058","name":"Appl cast plaster velpeau","description":"Application, cast; plaster velpeau","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4168","name":"Parenteral sol amino acid 3.","description":"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-06-05","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":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-06-05","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":"31030","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) without removal of antrochoanal polyps","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-05","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":"33202","name":"Insert epicard eltrd open","description":"Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median sternotomy, subxiphoid approach)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-05","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":"39402","name":"Mediastinoscpy w/lmph nod bx","description":"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26450","name":"Incision of palm tendon","description":"Tenotomy, flexor, palm, open, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78464","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-06-05","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":"35286","name":"Rpr blvsl grf oth/th vn lxtr","description":"Repair blood vessel with graft other than vein; lower extremity","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-06-05","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":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-06-05","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":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4083","name":"Enteral stomach tube levine","description":"Stomach tube - levine type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-06-05","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":"33511","name":"Cabg vein two","description":"Coronary artery bypass, vein only; 2 coronary venous grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92995","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-06-05","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":"B4168","name":"Parenteral sol amino acid 3.","description":"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27125","name":"Partial hip replacement","description":"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29345","name":"Application of long leg cast","description":"Application of long leg cast (thigh to toes);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-06-05","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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-05","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":"96119","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85345","name":"Coagulation time lee & white","description":"Coagulation time; lee and white","date_of_service":"2026-06-05","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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-06-05","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":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95834","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"97003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-06-05","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":"51798","name":"Us urine capacity measure","description":"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging","date_of_service":"2026-06-05","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86668","name":"Francisella tularensis","description":"Antibody; francisella tularensis","date_of_service":"2026-06-05","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":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-06-05","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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26500","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)","date_of_service":"2026-06-05","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":"U0003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31612","name":"Perq trchl pnxr ttrach aspir","description":"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection","date_of_service":"2026-06-05","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27645","name":"Resect tibia tumor","description":"Radical resection of tumor; tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84578","name":"Test urine urobilinogen","description":"Urobilinogen, urine; qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69440","name":"Exploration of middle ear","description":"Middle ear exploration through postauricular or ear canal incision","date_of_service":"2026-06-05","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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"37200","name":"Transcatheter biopsy","description":"Transcatheter biopsy","date_of_service":"2026-06-05","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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-06-05","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":"83861","name":"Microfluid analy tears","description":"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42215","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; major revision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-06-05","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":"15824","name":"Rhytidectomy forehead","description":"Rhytidectomy; forehead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28070","name":"Removal of foot joint lining","description":"Synovectomy; intertarsal or tarsometatarsal joint, each","date_of_service":"2026-06-05","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":"82157","name":"Assay of androstenedione","description":"Androstenedione","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-05","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":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-06-05","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28302","name":"Incision of ankle bone","description":"Osteotomy; talus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-05","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":"L6639","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-06-05","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":"51795","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-06-05","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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"35691","name":"Art trnsposj vertbrl carotid","description":"Transposition and/or reimplantation; vertebral to carotid artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"31291","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","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":"28615","name":"Repair foot dislocation","description":"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-05","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":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78591","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50546","name":"Laparoscopic nephrectomy","description":"Laparoscopy, surgical; nephrectomy, including partial ureterectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93539","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86356","name":"Mononuclear cell antigen","description":"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21209","name":"Reduction of facial bones","description":"Osteoplasty, facial bones; reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1769","name":"Guide wire","description":"Guide wire","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","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":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42971","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3215","name":"Orthopedic ftwear ladies oxf","description":"Orthopedic footwear, ladies shoe, oxford, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-06-05","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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-06-05","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":"37565","name":"Ligation int jugular vein","description":"Ligation, internal jugular vein","date_of_service":"2026-06-05","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":"A7011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24600","name":"Tx clsd elbow dislc w/o anes","description":"Treatment of closed elbow dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28600","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27750","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92996","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4081","name":"Enteral ng tubing w/ stylet","description":"Nasogastric tubing with stylet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-06-05","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0245T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87527","name":"Hepatitis g dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis g, quantification","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86664","name":"Epstein-barr nuclear antigen","description":"Antibody; epstein-barr (eb) virus, nuclear antigen (ebna)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77414","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15829","name":"Rhytidectomy smas flap","description":"Rhytidectomy; superficial musculoaponeurotic system (smas) flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"P2038","name":"Blood mucoprotein","description":"Mucoprotein, blood (seromucoid) (medical necessity procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83921","name":"Organic acid single quant","description":"Organic acid, single, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49653","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27268","name":"Cltx thigh fx w/mnpj","description":"Closed treatment of femoral fracture, proximal end, head; with manipulation","date_of_service":"2026-06-05","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":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"88107","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83908","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"47383","name":"Perq abltj lvr cryoablation","description":"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-06-05","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":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86063","name":"Antistreptolysin o screen","description":"Antistreptolysin 0; screen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-06-05","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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54600","name":"Reduce testis torsion","description":"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93531","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83951","name":"Oncoprotein dcp","description":"Oncoprotein; des-gamma-carboxy-prothrombin (dcp)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21461","name":"Optx mndblr fx wo ntrdntl","description":"Open treatment of mandibular fracture; without interdental fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35623","name":"Bpg axillary-pop/-tibial","description":"Bypass graft, with other than vein; axillary-popliteal or -tibial","date_of_service":"2026-06-05","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":"25900","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-05","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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25907","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; secondary closure or scar revision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62163","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41130","name":"Partial removal of tongue","description":"Glossectomy; hemiglossectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82485","name":"Assay chondroitin sulfate","description":"Chondroitin b sulfate, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24650","name":"Cltx rdl head/nck fx wo mnpj","description":"Closed treatment of radial head or neck fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84152","name":"Assay of psa complexed","description":"Prostate specific antigen (psa); complexed (direct measurement)","date_of_service":"2026-06-05","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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64714","name":"Revise low back nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83670","name":"Assay of lap enzyme","description":"Leucine aminopeptidase (lap)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42107","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with local flap closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35492","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78593","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0452","name":"Molecular pathology interpr","description":"Molecular pathology procedure; physician interpretation and report","date_of_service":"2026-06-05","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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1499","name":"Spinal orthosis nos","description":"Spinal orthosis, not otherwise specified","date_of_service":"2026-06-05","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":"42280","name":"Preparation palate mold","description":"Maxillary impression for palatal prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","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":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87265","name":"Pertussis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; bordetella pertussis/parapertussis","date_of_service":"2026-06-05","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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86309","name":"Heterophile antibody titer","description":"Heterophile antibodies; titer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-06-05","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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-06-05","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":"54500","name":"Biopsy of testis","description":"Biopsy of testis, needle (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-06-05","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":"71090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99251","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G6006","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-05","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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-06-05","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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90819","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"86694","name":"Herpes simplex nes antbdy","description":"Antibody; herpes simplex, non-specific type test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-06-05","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":"99336","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93539","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-05","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":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11960","name":"Insert tissue expander(s)","description":"Insertion of tissue expander(s) for other than breast, including subsequent expansion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-06-05","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":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32215","name":"Treat chest lining","description":"Pleural scarification for repeat pneumothorax","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82487","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31081","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-06-05","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":"44202","name":"Lap enterectomy","description":"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35454","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11982","name":"Remove drug implant device","description":"Removal, non-biodegradable drug delivery implant","date_of_service":"2026-06-05","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":"44650","name":"Repair bowel fistula","description":"Closure of enteroenteric or enterocolic fistula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85612","name":"Viper venom prothrombin time","description":"Russell viper venom time (includes venom); undiluted","date_of_service":"2026-06-05","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":"93012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-05","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":"92961","name":"Cardioversion electric int","description":"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"91307","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-06-05","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":"88325","name":"Consltj compre rvw rec reprt","description":"Consultation, comprehensive, with review of records and specimens, with report on referred material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-06-05","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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25295","name":"Release wrist/forearm tendon","description":"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78464","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-06-05","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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-06-05","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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37187","name":"Venous mech thrombectomy","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21010","name":"Incision of jaw joint","description":"Arthrotomy, temporomandibular joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7043","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"C1300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93652","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38571","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58800","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach","date_of_service":"2026-06-05","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":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84206","name":"Assay of proinsulin","description":"Proinsulin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-06-05","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":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"47122","name":"Extensive removal of liver","description":"Hepatectomy, resection of liver; trisegmentectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35321","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; axillary-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8680","name":"Implt neurostim elctr each","description":"Implantable neurostimulator electrode, each","date_of_service":"2026-06-05","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":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43267","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21245","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; partial","date_of_service":"2026-06-05","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":"93590","name":"Perq transcath cls mitral","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve","date_of_service":"2026-06-05","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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59320","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; vaginal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6005","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-05","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":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-05","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":"29715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-05","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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41010","name":"Incision of tongue fold","description":"Incision of lingual frenum (frenotomy)","date_of_service":"2026-06-05","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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"60502","name":"Re-explore parathyroids","description":"Parathyroidectomy or exploration of parathyroid(s); re-exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23106","name":"Arthrotomy strnclav joint","description":"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4215","name":"Sterile needle","description":"Needle, sterile, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24470","name":"Hemiepiphyseal arrest","description":"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15341","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-06-05","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":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-06-05","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":"36822","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-06-05","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":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30468","name":"Rpr nsl vlv collapse w/implt","description":"Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-05","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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37224","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27370","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68540","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; frontal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77401","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84207","name":"Assay of vitamin b-6","description":"Pyridoxal phosphate (vitamin b-6)","date_of_service":"2026-06-05","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":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42160","name":"Treatment mouth roof lesion","description":"Destruction of lesion, palate or uvula (thermal, cryo or chemical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"47740","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0247T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","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":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-06-05","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":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"21356","name":"Opn tx dprsd zygomatic arch","description":"Open treatment of depressed zygomatic arch fracture (eg, gillies approach)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"58760","name":"Fimbrioplasty","description":"Fimbrioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85445","name":"Heinz bodies induced","description":"Heinz bodies; induced, acetyl phenylhydrazine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29025","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-06-05","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":"15650","name":"Transfer skin pedicle flap","description":"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, walking tube), any location","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23800","name":"Arthrodesis glenohumeral jt","description":"Arthrodesis, glenohumeral joint;","date_of_service":"2026-06-05","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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-06-05","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":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0368","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"49204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46210","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"50070","name":"Nl comp cgen kdn abnormality","description":"Nephrolithotomy; complicated by congenital kidney abnormality","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"83857","name":"Assay of methemalbumin","description":"Methemalbumin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"11041","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-05","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24495","name":"Decompression fasct forearm","description":"Decompression fasciotomy, forearm, with brachial artery exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"38221","name":"Dx bone marrow biopsies","description":"Diagnostic bone marrow; biopsy(ies)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"15920","name":"Exc coccygl pr ulc prim sutr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-06-05","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":"80185","name":"Assay of phenytoin total","description":"Phenytoin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-06-05","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":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38120","name":"Laparoscopy splenectomy","description":"Laparoscopy, surgical, splenectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44970","name":"Laparoscopy appendectomy","description":"Laparoscopy, surgical, appendectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21280","name":"Medial canthopexy","description":"Medial canthopexy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-06-05","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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61340","name":"Subtemporal cranial dcmprn","description":"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95060","name":"Oph mucous membrane tests","description":"Ophthalmic mucous membrane tests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"86329","name":"Immunodiffusion nes","description":"Immunodiffusion; not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"19355","name":"Correct inverted nipple(s)","description":"Correction of inverted nipples","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86353","name":"Lymphocyte transformation","description":"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8189","name":"Trach supply noc","description":"Tracheostomy supply, not otherwise classified","date_of_service":"2026-06-05","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":"E8001","name":"Upright gait trainer","description":"Gait trainer, pediatric size, upright support, includes all accessories and components","date_of_service":"2026-06-05","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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"C1300","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-05","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":"45387","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-06-05","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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-05","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":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"54520","name":"Removal of testis","description":"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","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"],"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":"2026-06-05","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":"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":"2026-06-05","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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"68371","name":"Harvest eye tissue alograft","description":"Harvesting conjunctival allograft, living donor","date_of_service":"2026-06-05","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":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"99241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-06-05","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":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","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":"44625","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23071","name":"Exc shoulder les sc 3 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-06-05","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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-06-05","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":"24110","name":"Exc/curtg b1 cst/b9 tum hum","description":"Excision or curettage of bone cyst or benign tumor, humerus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27475","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur","date_of_service":"2026-06-05","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29889","name":"Arthrs aid pcl rpr/agmntj","description":"Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69405","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-06-05","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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-06-05","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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8428","name":"Ready gradient gauntlet","description":"Gradient pressure aid (gauntlet), ready made","date_of_service":"2026-06-05","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":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43330","name":"Esophagomyotomy abdominal","description":"Esophagomyotomy (heller type); abdominal approach","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-05","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":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-06-05","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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86708","name":"Hepatitis a antibody","description":"Hepatitis a antibody (haab)","date_of_service":"2026-06-05","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":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-06-05","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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"99188","name":"App topical fluoride varnish","description":"Application of topical fluoride varnish by a physician or other qualified health care professional","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33611","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62284","name":"Injection for myelogram","description":"Injection procedure for myelography and/or computed tomography, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G2061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28805","name":"Amputation thru metatarsal","description":"Amputation, foot; transmetatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82507","name":"Assay of citrate","description":"Citrate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-06-05","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":"86735","name":"Mumps antibody","description":"Antibody; mumps","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15330","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"29590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67255","name":"Reinforce/graft eye wall","description":"Scleral reinforcement (separate procedure); with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84087","name":"Assay phosphohexose enzymes","description":"Phosphohexose isomerase","date_of_service":"2026-06-05","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-06-05","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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92352","name":"Fit aphakia spectcl monofocl","description":"Fitting of spectacle prosthesis for aphakia; monofocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31592","name":"Cricotracheal resection","description":"Cricotracheal resection","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69601","name":"Revj mstdc rsltg compl mstdc","description":"Revision mastoidectomy; resulting in complete mastoidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"64611","name":"Chemodenerv saliv glands","description":"Chemodenervation of parotid and submandibular salivary glands, bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86226","name":"Dna antibody single strand","description":"Deoxyribonucleic acid (dna) antibody; single stranded","date_of_service":"2026-06-05","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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-06-05","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":"84480","name":"Assay triiodothyronine (t3)","description":"Triiodothyronine t3; total (tt-3)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61796","name":"Srs cranial lesion simple","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"58543","name":"Lsh uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4262","name":"Temporary tear duct plug","description":"Temporary, absorbable lacrimal duct implant, each","date_of_service":"2026-06-05","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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"31820","name":"Closure of windpipe lesion","description":"Surgical closure tracheostomy or fistula; without plastic repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-06-05","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":"24155","name":"Resection of elbow joint","description":"Resection of elbow joint (arthrectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88740","name":"Transcutaneous carboxyhb","description":"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-06-05","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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-05","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":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83890","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0441","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0112","name":"Potassium hydroxide preps","description":"All potassium hydroxide (koh) preparations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58925","name":"Removal of ovarian cyst(s)","description":"Ovarian cystectomy, unilateral or bilateral","date_of_service":"2026-06-05","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":"33513","name":"Cabg vein four","description":"Coronary artery bypass, vein only; 4 coronary venous grafts","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-06-05","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":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4590","name":"Special casting material","description":"Special casting material (e.g., fiberglass)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86063","name":"Antistreptolysin o screen","description":"Antistreptolysin 0; screen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0274","name":"Over-bed table","description":"Over-bed table","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-06-05","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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-05","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":"21045","name":"Extensive jaw surgery","description":"Excision of malignant tumor of mandible; radical resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-06-05","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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27766","name":"Optx medial ankle fx","description":"Open treatment of medial malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["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":"2026-06-05","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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-05","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":"54440","name":"Repair of penis","description":"Plastic operation of penis for injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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, furn","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","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":"P2038","name":"Blood mucoprotein","description":"Mucoprotein, blood (seromucoid) (medical necessity procedure)","date_of_service":"2026-06-05","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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27005","name":"Tenotomy hip flexor open","description":"Tenotomy, hip flexor(s), open (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-06-05","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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-05","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":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"22521","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27652","name":"Repair/graft achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon; with graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25545","name":"Optx ulnar shft fx int fixj","description":"Open treatment of ulnar shaft fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"28126","name":"Partial removal of toe","description":"Resection, partial or complete, phalangeal base, each toe","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44136","name":"Intestine transplant live","description":"Intestinal allotransplantation; from living donor","date_of_service":"2026-06-05","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":"95943","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"C1874","name":"Stent, coated/cov w/del sys","description":"Stent, coated/covered, with delivery system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82649","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61556","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; frontal or parietal bone flap","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82575","name":"Creatinine clearance test","description":"Creatinine; clearance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"34520","name":"Cross-over vein graft","description":"Cross-over vein graft to venous system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","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":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36810","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (scribner type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-05","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":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-06-05","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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4765","name":"Dialysate conc pow per pack","description":"Dialysate concentrate, powder, additive for peritoneal dialysis, per packet","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"19330","name":"Rmvl ruptured breast implant","description":"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-06-05","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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-06-05","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-06-05","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":"0398T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-06-05","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":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-06-05","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":"32661","name":"Thoracoscopy w/pericard exc","description":"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23035","name":"Incision bone cortex sho","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5020","name":"Conformity evaluation","description":"Conformity evaluation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"65778","name":"Cover eye w/membrane","description":"Placement of amniotic membrane on the ocular surface; without sutures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21320","name":"Clsd tx nsl fx w/mnpj&stablj","description":"Closed treatment of nasal bone fracture with manipulation; with stabilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0295T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"36148","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64435","name":"Njx aa&/strd paracrv nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31584","name":"Laryngoplasty fx rdctj fixj","description":"Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30450","name":"Revision of nose","description":"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21453","name":"Cltx mndblr fx ntrdntl fixj","description":"Closed treatment of mandibular fracture with interdental fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28322","name":"Repair of metatarsals","description":"Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4537","name":"Reusable underpad bed size","description":"Incontinence product, protective underpad, reusable, bed size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-06-05","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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9512","name":"Tc99m pertechnetate","description":"Technetium tc-99m pertechnetate, diagnostic, per millicurie","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0172T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-06-05","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":"26020","name":"Drain hand tendon sheath","description":"Drainage of tendon sheath, digit and/or palm, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"C8900","name":"Mra w/cont, abd","description":"Magnetic resonance angiography with contrast, abdomen","date_of_service":"2026-06-05","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":"33502","name":"Coronary artery correction","description":"Repair of anomalous coronary artery from pulmonary artery origin; by ligation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81190","name":"Cstb gene known famil vrnt","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; known familial variant(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84512","name":"Assay of troponin qual","description":"Troponin, qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64708","name":"Revise arm/leg nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-05","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":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8424","name":"Ready gradient sleeve","description":"Gradient pressure aid (sleeve), ready made","date_of_service":"2026-06-05","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":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-06-05","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":"64624","name":"Dstrj nulyt agt gnclr nrv","description":"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed","date_of_service":"2026-06-05","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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-05","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":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-06-05","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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99355","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-05","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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","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":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85397","name":"Clotting funct activity","description":"Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, adamts-13), each analyte","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21407","name":"Opn tx orbit fx w/implant","description":"Open treatment of fracture of orbit, except blowout; with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-06-05","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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"34201","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; femoropopliteal, aortoiliac artery, by leg incision","date_of_service":"2026-06-05","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":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-06-05","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":"87450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-05","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":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","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":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88271","name":"Cytogenetics dna probe","description":"Molecular cytogenetics; dna probe, each (eg, fish)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56634","name":"Vlvctmy rad comp uni lymphad","description":"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","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":"99217","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64772","name":"Incision of spinal nerve","description":"Transection or avulsion of other spinal nerve, extradural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"58541","name":"Lsh uterus 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"56633","name":"Vulvectomy radical complete","description":"Vulvectomy, radical, complete;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38700","name":"Removal of lymph nodes neck","description":"Suprahyoid lymphadenectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19305","name":"Mast radical","description":"Mastectomy, radical, including pectoral muscles, axillary lymph nodes","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","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":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","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":"27685","name":"Revision of lower leg tendon","description":"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26842","name":"Thumb fusion with graft","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85576","name":"Blood platelet aggregation","description":"Platelet, aggregation (in vitro), each agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"75966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-06-05","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":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-06-05","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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92326","name":"Replacement of contact lens","description":"Replacement of contact lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-06-05","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":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"S8428","name":"Ready gradient gauntlet","description":"Gradient pressure aid (gauntlet), ready made","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21137","name":"Rdctj forehead cntrg only","description":"Reduction forehead; contouring only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["11004","11005","11101","11102","11103","11104","11105","11106","11109","11120","11351","11352","11354","11355","11356","11357","11358","11359","11360","11361","11362","11363","11364","11365","11366","11367","11368","11369","11370","11371","11372","11373","11374","11375","11377","11378","11379","11380","11381","11385","11386","11390","11405","11411","11412","11413","11414","11415","11416","11417","11418","11419","11420","11421","11422","11423","11424","11425","11426","11427","11428","11429","11430","11431","11432","11433","11434","11435","11436","11437","11439","11451","11499","11690","11691","11692","11693","11694","11695","11697"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.45,"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-05","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":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11719","name":"Trim nail(s) any number","description":"Trimming of nondystrophic nails, any number","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"37207","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-06-05","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":"A6412","name":"Occlusive eye patch","description":"Eye patch, occlusive, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0504T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57425","name":"Laparoscopy surg colpopexy","description":"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-06-05","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":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-06-05","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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-06-05","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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86778","name":"Toxoplasma antibody igm","description":"Antibody; toxoplasma, igm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"T4526","name":"Adult size pull-on med","description":"Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each","date_of_service":"2026-06-05","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":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"87107","name":"Fungi identification mold","description":"Culture, fungi, definitive identification, each organism; mold","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25805","name":"Arthrd wrist w/sliding graft","description":"Arthrodesis, wrist; with sliding graft","date_of_service":"2026-06-05","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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-05","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":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"0208T","name":"Audiometry air only","description":"Pure tone audiometry (threshold), automated; air only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77403","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82553","name":"Creatine mb fraction","description":"Creatine kinase (ck), (cpk); mb fraction only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C9113","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35656","name":"Bpg femoral-popliteal","description":"Bypass graft, with other than vein; femoral-popliteal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-05","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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"82307","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92532","name":"Positional nystagmus test","description":"Positional nystagmus test","date_of_service":"2026-06-05","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":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-06-05","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":"33430","name":"Replacement of mitral valve","description":"Replacement, mitral valve, with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49651","name":"Lap ing hernia repair recur","description":"Laparoscopy, surgical; repair recurrent inguinal hernia","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"0564T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43652","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective","date_of_service":"2026-06-05","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":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"37202","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29824","name":"Sho arthrs srg dstl claviclc","description":"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69840","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-06-05","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":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78587","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21270","name":"Augmentation cheek bone","description":"Malar augmentation, prosthetic material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35536","name":"Art byp grft splenorenal","description":"Bypass graft, with vein; splenorenal","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23500","name":"Cltx clavicular fx w/o mnpj","description":"Closed treatment of clavicular fracture; without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-06-05","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":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77032","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"T4524","name":"Adult size brief/diaper xl","description":"Adult sized disposable incontinence product, brief/diaper, extra large, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92990","name":"Revision of pulmonary valve","description":"Percutaneous balloon valvuloplasty; pulmonary valve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49600","name":"Repair umbilical lesion","description":"Repair of small omphalocele, with primary closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-06-05","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-06-05","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":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"65110","name":"Removal of eye","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0446","name":"Intens behave ther cardio dx","description":"Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes","date_of_service":"2026-06-05","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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-06-05","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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88283","name":"Chromosome banding study","description":"Chromosome analysis; additional specialized banding technique (eg, nor, c-banding)","date_of_service":"2026-06-05","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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"53855","name":"Insert prost urethral stent","description":"Insertion of a temporary prostatic urethral stent, including urethral measurement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-06-05","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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"63702","name":"Repair of spinal herniation","description":"Repair of meningocele; larger than 5 cm diameter","date_of_service":"2026-06-05","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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-06-05","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":"27769","name":"Optx post ankle fx","description":"Open treatment of posterior malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-06-05","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":"64585","name":"Rev/rmv perph nstim eltrd ra","description":"Revision or removal of peripheral neurostimulator electrode array","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-05","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":"21081","name":"Impres&prep mndbl res prosth","description":"Impression and custom preparation; mandibular resection prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40702","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45345","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25109","name":"Excise tendon forearm/wrist","description":"Excision of tendon, forearm and/or wrist, flexor or extensor, each","date_of_service":"2026-06-05","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":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58920","name":"Partial removal of ovary(s)","description":"Wedge resection or bisection of ovary, unilateral or bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"64611","name":"Chemodenerv saliv glands","description":"Chemodenervation of parotid and submandibular salivary glands, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"23200","name":"Radical rescj tumor clavicle","description":"Radical resection of tumor; clavicle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43405","name":"Ligate/staple esophagus","description":"Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-05","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":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82941","name":"Assay of gastrin","description":"Gastrin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41113","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; posterior one-third","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86941","name":"Hemolysins/agglutinins","description":"Hemolysins and agglutinins; incubated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26055","name":"Incise finger tendon sheath","description":"Tendon sheath incision (eg, for trigger finger)","date_of_service":"2026-06-05","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":"92981","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84490","name":"Assay of feces for trypsin","description":"Trypsin; feces, quantitative, 24-hour collection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"41108","name":"Biopsy of floor of mouth","description":"Biopsy of floor of mouth","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83825","name":"Assay of mercury","description":"Mercury, quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"G0430","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-06-05","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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-05","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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65280","name":"Repair of eye wound","description":"Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49557","name":"Rerepair fem hernia blocked","description":"Repair recurrent femoral hernia; incarcerated or strangulated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26025","name":"Drainage of palm bursa","description":"Drainage of palmar bursa; single, bursa","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0064A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75564","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38242","name":"Transplt allo lymphocytes","description":"Allogeneic lymphocyte infusions","date_of_service":"2026-06-05","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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26340","name":"Manipulate finger w/anesth","description":"Manipulation, finger joint, under anesthesia, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64640","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; other peripheral nerve or branch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37201","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32652","name":"Thoracoscopy rem totl cortex","description":"Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66165","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"42825","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; younger than age 12","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49568","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-06-05","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":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","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":"11106","name":"Incal bx skn single les","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion","date_of_service":"2026-06-05","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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-05","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":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-06-05","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":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-06-05","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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-05","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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-05","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":"24655","name":"Cltx rdl head/nck fx w/mnpj","description":"Closed treatment of radial head or neck fracture; with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29105","name":"Application long arm splint","description":"Application of long arm splint (shoulder to hand)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-06-05","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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35484","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62292","name":"Njx chemonucleolysis lmbr","description":"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-06-05","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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-06-05","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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45305","name":"Proctosigmoidoscopy w/bx","description":"Proctosigmoidoscopy, rigid; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86747","name":"Parvovirus antibody","description":"Antibody; parvovirus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"65093","name":"Revise eye with implant","description":"Evisceration of ocular contents; with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0031A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69720","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; lateral to geniculate ganglion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-06-05","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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64553","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; cranial nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G2058","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"62272","name":"Ther spi pnxr drg csf","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter);","date_of_service":"2026-06-05","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":"89055","name":"Leukocyte assessment fecal","description":"Leukocyte assessment, fecal, qualitative or semiquantitative","date_of_service":"2026-06-05","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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-06-05","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":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-05","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":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-05","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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28150","name":"Removal of toe","description":"Phalangectomy, toe, each toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"96101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29906","name":"Subtalar arthro w/deb","description":"Arthroscopy, subtalar joint, surgical; with debridement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-05","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":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0241U","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-06-05","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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69805","name":"Explore inner ear","description":"Endolymphatic sac operation; without shunt","date_of_service":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-05","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":"66600","name":"Remove iris and lesion","description":"Iridectomy, with corneoscleral or corneal section; for removal of lesion","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-06-05","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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38382","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0275T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-06-05","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":"43600","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33234","name":"Removal of pacemaker system","description":"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular","date_of_service":"2026-06-05","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":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"40650","name":"Rpr lip fth vermilion only","description":"Repair lip, full thickness; vermilion only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-06-05","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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0042T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33233","name":"Removal of pm generator","description":"Removal of permanent pacemaker pulse generator only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"49651","name":"Lap ing hernia repair recur","description":"Laparoscopy, surgical; repair recurrent inguinal hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-06-05","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-06-05","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99177","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis","date_of_service":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-05","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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","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":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-06-05","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":"26055","name":"Incise finger tendon sheath","description":"Tendon sheath incision (eg, for trigger finger)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","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":"A6262","name":"Wound filler dry form / gram","description":"Wound filler, dry form, per gram, not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86781","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-06-05","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":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"24066","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62270","name":"Dx lmbr spi pnxr","description":"Spinal puncture, lumbar, diagnostic;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"L2770","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"69706","name":"Nps surg dilat eust tube bi","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44137","name":"Remove intestinal allograft","description":"Removal of transplanted intestinal allograft, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"99185","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41874","name":"Alveoloplasty each quadrant","description":"Alveoloplasty, each quadrant (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27252","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85301","name":"Antithrombin iii antigen","description":"Clotting inhibitors or anticoagulants; antithrombin iii, antigen assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87517","name":"Hepatitis b dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, quantification","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-06-05","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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-06-05","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-06-05","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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32445","name":"Removal of lung extrapleural","description":"Removal of lung, pneumonectomy; extrapleural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86870","name":"Rbc antibody identification","description":"Antibody identification, rbc antibodies, each panel for each serum technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-06-05","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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-06-05","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","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":"36261","name":"Revision of infusion pump","description":"Revision of implanted intra-arterial infusion pump","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92993","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51605","name":"Preparation for bladder xray","description":"Injection procedure and placement of chain for contrast and/or chain urethrocystography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"ATP06","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27664","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68811","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15750","name":"Neurovascular pedicle flap","description":"Flap; neurovascular pedicle","date_of_service":"2026-06-05","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":"0548T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","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":"82638","name":"Assay of dibucaine number","description":"Dibucaine number","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32671","name":"Thoracoscopy pneumonectomy","description":"Thoracoscopy, surgical; with removal of lung (pneumonectomy)","date_of_service":"2026-06-05","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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-06-05","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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86732","name":"Mucormycosis antibody","description":"Antibody; mucormycosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","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":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4262","name":"Temporary tear duct plug","description":"Temporary, absorbable lacrimal duct implant, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83891","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"28210","name":"Repair/graft of foot tendon","description":"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63278","name":"Bx/exc xdrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28446","name":"Opn osteochondrl agrft talus","description":"Open osteochondral autograft, talus (includes obtaining graft[s])","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51980","name":"Construct bladder opening","description":"Cutaneous vesicostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75993","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22903","name":"Exc abd les sc 3 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44383","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38214","name":"Volume deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0498T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S4989","name":"Contracept iud","description":"Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50945","name":"Laparoscopy ureterolithotomy","description":"Laparoscopy, surgical; ureterolithotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-06-05","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":"84449","name":"Assay of transcortin","description":"Transcortin (cortisol binding globulin)","date_of_service":"2026-06-05","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":"93542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-06-05","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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"37208","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75959","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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":"35490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35371","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; common femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85385","name":"Fibrinogen antigen","description":"Fibrinogen; antigen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33237","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28226","name":"Release of foot tendons","description":"Tenolysis, extensor, foot; multiple tendons","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81285","name":"Fxn gene charac alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4570","name":"Splint","description":"Splint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27120","name":"Reconstruction of hip socket","description":"Acetabuloplasty; (eg, whitman, colonna, haygroves, or cup type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"63741","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45383","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"P9021","name":"Red blood cells unit","description":"Red blood cells, each unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-06-05","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":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"63271","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","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":"0150T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28312","name":"Revision of toe","description":"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"E0463","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21083","name":"Impres&prep paltl lft prosth","description":"Impression and custom preparation; palatal lift prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86038","name":"Antinuclear antibodies","description":"Antinuclear antibodies (ana);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82742","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-06-05","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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-06-05","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":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83698","name":"Assay lipoprotein pla2","description":"Lipoprotein-associated phospholipase a2 (lp-pla2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-06-05","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":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"20661","name":"Application halo cranial","description":"Application of halo, including removal; cranial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37209","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"23331","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["00501","00544","06390","10301","10302","10303","10304","10305","10306","10307","10308","10309","10310","10311","10312","10313","10314","10451","10452","10453","10454","10455","10456","10457","10458","10459","10460","10461","10462","10463","10464","10465","10466","10467","10468","10469","10470","10471","10472","10473","10474","10475","10499","10501","10502","10503","10504","10505","10506","10507","10510","10511","10514","10517","10518","10519","10520","10521","10522","10523","10526","10527","10528","10530","10532","10533","10535","10536","10538","10540","10543","10545","10546","10547","10548","10549","10550","10551","10552","10553","10557","10558","10560","10562","10566","10567","10570","10571","10572","10573","10576","10577","10578","10580","10583","10587","10588","10589","10590","10591","10594","10595","10596","10597","10598","10601","10602","10603","10604","10605","10606","10607","10610","10650","10701","10702","10703","10704","10705","10706","10707","10708","10709","10710","10801","10802","10803","10804","10805","10901","10911","10913","10920","10923","10927","10931","10952","10954","10956","10960","10962","10964","10965","10968","10970","10974","10976","10977","10980","10982","10983","10984","10986","10989","10993","10994","11001","11002","11003","11010","11020","11021","11022","11023","11024","11025","11026","11027","11030","11040","11041","11042","11043","11044","11050","11051","11052","11053","11054","11055","11096","11099","11201","11202","11203","11204","11205","11206","11207","11208","11209","11210","11211","11212","11213","11214","11215","11216","11217","11218","11219","11220","11221","11222","11223","11224","11225","11226","11228","11229","11230","11231","11232","11233","11234","11235","11236","11237","11238","11239","11240","11241","11242","11243","11244","11245","11247","11248","11249","11251","11252","11254","11255","11256","11501","11507","11509","11510","11514","11516","11518","11520","11530","11531","11535","11536","11542","11545","11547","11548","11549","11550","11551","11552","11553","11554","11555","11556","11557","11558","11559","11560","11561","11563","11565","11566","11568","11569","11570","11571","11572","11575","11576","11577","11579","11580","11581","11582","11590","11592","11594","11595","11596","11597","11598","11599","11701","11702","11703","11704","11705","11706","11707","11708","11709","11710","11713","11714","11715","11716","11717","11718","11719","11720","11721","11722","11724","11725","11726","11727","11729","11730","11731","11732","11733","11735","11736","11737","11738","11739","11740","11741","11742","11743","11746","11747","11749","11750","11751","11752","11753","11754","11755","11756","11757","11758","11760","11762","11763","11764","11765","11766","11767","11768","11769","11770","11771","11772","11773","11774","11775","11776","11777","11778","11779","11780","11782","11783","11784","11786","11787","11788","11789","11790","11791","11792","11793","11794","11795","11796","11797","11798","11801","11802","11803","11804","11815","11819","11853","11854","11855","11901","11930","11931","11932","11933","11934","11935","11937","11939","11940","11941","11942","11944","11946","11947","11948","11949","11950","11951","11952","11953","11954","11955","11956","11957","11958","11959","11960","11961","11962","11963","11964","11965","11967","11968","11969","11970","11971","11972","11973","11975","11976","11977","11978","11980"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"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":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"L7900","name":"Male vacuum erection system","description":"Male vacuum erection system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87900","name":"Phenotype infect agent drug","description":"Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","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":"90828","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"53270","name":"Removal of urethra gland","description":"Excision or fulguration; skenes glands","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29715","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63620","name":"Srs spinal lesion","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion","date_of_service":"2026-06-05","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":"0358T","name":"Bia whole body","description":"Bioelectrical impedance analysis whole body composition assessment, with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28715","name":"Arthrodesis triple","description":"Arthrodesis; triple","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-06-05","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":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93721","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15650","name":"Transfer skin pedicle flap","description":"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, walking tube), any location","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41806","name":"Removal foreign body jawbone","description":"Removal of embedded foreign body from dentoalveolar structures; bone","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0208T","name":"Audiometry air only","description":"Pure tone audiometry (threshold), automated; air only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-06-05","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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-05","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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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","41","21","26","66","52","02","42","24","22","10","56","31","08","06","51","53","61","07","19","34","05","18"],"billing_code_modifier":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"49585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0325","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-06-05","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","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":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84119","name":"Test urine for porphyrins","description":"Porphyrins, urine; qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-06-05","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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22864","name":"Rmvl tot arthrp 1ntrspc crv","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-06-05","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":"49080","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-06-05","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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-06-05","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":"27654","name":"Repair of achilles tendon","description":"Repair, secondary, achilles tendon, with or without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"65140","name":"Attach ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles attached to implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"99144","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1340","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"41828","name":"Excision of gum lesion","description":"Excision of hyperplastic alveolar mucosa, each quadrant (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G6010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"89136","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-06-05","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":"27610","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95834","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82495","name":"Assay of chromium","description":"Chromium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37565","name":"Ligation int jugular vein","description":"Ligation, internal jugular vein","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84585","name":"Assay of urine vma","description":"Vanillylmandelic acid (vma), urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"34900","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-06-05","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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-06-05","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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-06-05","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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","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":"45382","name":"Colonoscopy w/control bleed","description":"Colonoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50600","name":"Exploration of ureter","description":"Ureterotomy with exploration or drainage (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77408","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-06-05","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":"85175","name":"Blood clot lysis time","description":"Clot lysis time, whole blood dilution","date_of_service":"2026-06-05","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":"24615","name":"Optx aqt/chrnc elbow dislc","description":"Open treatment of acute or chronic elbow dislocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64622","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0295T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83907","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"71023","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99241","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","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":"75956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85290","name":"Clot factor xiii fibrin stab","description":"Clotting; factor xiii (fibrin stabilizing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26844","name":"Fusion/graft of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27238","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69605","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86632","name":"Chlamydia igm antibody","description":"Antibody; chlamydia, igm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"83906","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0499T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"39501","name":"Repair diaphragm laceration","description":"Repair, laceration of diaphragm, any approach","date_of_service":"2026-06-05","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":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-06-05","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":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35540","name":"Art byp grft aortbifemoral","description":"Bypass graft, with vein; aortobifemoral","date_of_service":"2026-06-05","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":"45327","name":"Proctosigmoidoscopy w/stent","description":"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37140","name":"Revision of circulation","description":"Venous anastomosis, open; portocaval","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L7261","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11977","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"57283","name":"Colpopexy intraperitoneal","description":"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-06-05","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":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-06-05","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":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26645","name":"Treat thumb fracture","description":"Closed treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"S3819","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86735","name":"Mumps antibody","description":"Antibody; mumps","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62268","name":"Drain spinal cord cyst","description":"Percutaneous aspiration, spinal cord cyst or syrinx","date_of_service":"2026-06-05","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":"58800","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35538","name":"Art byp grft aortobi-iliac","description":"Bypass graft, with vein; aortobi-iliac","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0150T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64857","name":"Repair arm/leg nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-05","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":"80200","name":"Assay of tobramycin","description":"Tobramycin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62143","name":"Rpl b1 flp/prostc plate skl","description":"Replacement of bone flap or prosthetic plate of skull","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00634","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-06-05","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":"71040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"35456","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-05","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":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A4772","name":"Blood glucose test strips","description":"Blood glucose test strips, for dialysis, per 50","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-06-05","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":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93299","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82642","name":"Dihydrotestosterone","description":"Dihydrotestosterone (dht)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-06-05","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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"T4536","name":"Reusable pull-on any size","description":"Incontinence product, protective underwear/pull-on, reusable, any size, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55400","name":"Repair of sperm duct","description":"Vasovasostomy, vasovasorrhaphy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75562","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-05","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-05","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":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-05","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":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-06-05","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":"83896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28530","name":"Treat sesamoid bone fracture","description":"Closed treatment of sesamoid fracture","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82943","name":"Assay of glucagon","description":"Glucagon","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28666","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"44900","name":"I&d appendix abscess open","description":"Incision and drainage of appendiceal abscess, open","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33926","name":"Repr pul art unifocal w/cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54001","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn","date_of_service":"2026-06-05","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":"40814","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"61860","name":"Implant neuroelectrodes","description":"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29906","name":"Subtalar arthro w/deb","description":"Arthroscopy, subtalar joint, surgical; with debridement","date_of_service":"2026-06-05","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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-06-05","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":"96523","name":"Irrig drug delivery device","description":"Irrigation of implanted venous access device for drug delivery systems","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","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":"64721","name":"Carpal tunnel surgery","description":"Neuroplasty and/or transposition; median nerve at carpal tunnel","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67500","name":"Inject/treat eye socket","description":"Retrobulbar injection; medication (separate procedure, does not include supply of medication)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-06-05","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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-06-05","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":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-06-05","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":"A4480","name":"Vabra aspirator","description":"Vabra aspirator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"46608","name":"Anoscopy remove for body","description":"Anoscopy; with removal of foreign body","date_of_service":"2026-06-05","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":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64831","name":"Repair of digit nerve","description":"Suture of digital nerve, hand or foot; 1 nerve","date_of_service":"2026-06-05","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25248","name":"Remove forearm foreign body","description":"Exploration with removal of deep foreign body, forearm or wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-05","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":"43647","name":"Lap impl electrode antrum","description":"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54560","name":"Exploration for testis","description":"Exploration for undescended testis with abdominal exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58301","name":"Remove intrauterine device","description":"Removal of intrauterine device (iud)","date_of_service":"2026-06-05","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":"43641","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-06-05","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":"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 underst","date_of_service":"2026-06-05","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":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30000","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal, internal approach","date_of_service":"2026-06-05","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":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84127","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1768","name":"Graft, vascular","description":"Graft, vascular","date_of_service":"2026-06-05","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":"76930","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36597","name":"Reposition venous catheter","description":"Repositioning of previously placed central venous catheter under fluoroscopic guidance","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84061","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"29836","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-06-05","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":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33507","name":"Repair art intramural","description":"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-06-05","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":"57260","name":"Cmbn ant pst colprhy","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77083","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8688","name":"Implt nrostm pls gen dua non","description":"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-06-05","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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-05","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":"36160","name":"Establish access to aorta","description":"Introduction of needle or intracatheter, aortic, translumbar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"38790","name":"Inject for lymphatic x-ray","description":"Injection procedure; lymphangiography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"86804","name":"Hep c ab test confirm","description":"Hepatitis c antibody; confirmatory test (eg, immunoblot)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-05","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15828","name":"Rhytidectomy cheek chn & nck","description":"Rhytidectomy; cheek, chin, and neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"34806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80170","name":"Assay of gentamicin","description":"Gentamicin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32557","name":"Insert cath pleura w/ image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"10005","name":"Fna bx w/us gdn 1st les","description":"Fine needle aspiration biopsy, including ultrasound guidance; first lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"51772","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82030","name":"Assay of adp & amp","description":"Adenosine, 5-monophosphate, cyclic (cyclic amp)","date_of_service":"2026-06-05","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"86771","name":"Shigella antibody","description":"Antibody; shigella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35281","name":"Rpr blvsl gr ot/th vn ntr-ab","description":"Repair blood vessel with graft other than vein; intra-abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21040","name":"Excise mandible lesion","description":"Excision of benign tumor or cyst of mandible, by enucleation and/or curettage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88741","name":"Transcutaneous methb","description":"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-06-05","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":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37222","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0243","name":"Toilet rail","description":"Toilet rail, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33362","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open femoral artery approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35256","name":"Repair blvsl vn grf lxtr","description":"Repair blood vessel with vein graft; lower extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43210","name":"Egd esophagogastrc fndoplsty","description":"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4928","name":"Surgical mask","description":"Surgical mask, per 20","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":["KL","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":"2026-06-05","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":"40720","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46940","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"15833","name":"Exc excessive skin leg","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19366","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35459","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-06-05","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":"28545","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3213","name":"Benesch boot pair child","description":"Benesch boot, pair, child","date_of_service":"2026-06-05","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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"36835","name":"Insertion thomas shunt","description":"Insertion of thomas shunt (separate procedure)","date_of_service":"2026-06-05","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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"87804","name":"Influenza assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; influenza","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28008","name":"Incision of foot fascia","description":"Fasciotomy, foot and/or toe","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-06-05","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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-06-05","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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92072","name":"Fitg c-lens keratoconus 1st","description":"Fitting of contact lens for management of keratoconus, initial fitting","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-06-05","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":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27750","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation","date_of_service":"2026-06-05","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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64520","name":"N block lumbar/thoracic","description":"Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-06-05","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":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"83026","name":"Hemoglobin copper sulfate","description":"Hemoglobin; by copper sulfate method, non-automated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"01180","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33221","name":"Insert pulse gen mult leads","description":"Insertion of pacemaker pulse generator only; with existing multiple leads","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35216","name":"Rpr blvsl dir ntrthrc wo byp","description":"Repair blood vessel, direct; intrathoracic, without bypass","date_of_service":"2026-06-05","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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-06-05","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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33645","name":"Revision of heart veins","description":"Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53852","name":"Prostatic rf thermotx","description":"Transurethral destruction of prostate tissue; by radiofrequency thermotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"36592","name":"Collect blood from picc","description":"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"33010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36500","name":"Insertion of catheter vein","description":"Venous catheterization for selective organ blood sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41800","name":"Drainage of gum lesion","description":"Drainage of abscess, cyst, hematoma from dentoalveolar structures","date_of_service":"2026-06-05","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":"54680","name":"Relocation of testis(es)","description":"Transplantation of testis(es) to thigh (because of scrotal destruction)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95115","name":"Immunotherapy one injection","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; single injection","date_of_service":"2026-06-05","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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"87140","name":"Culture type immunofluoresc","description":"Culture, typing; immunofluorescent method, each antiserum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-06-05","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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-06-05","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":"43258","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97762","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65772","name":"Correction of astigmatism","description":"Corneal relaxing incision for correction of surgically induced astigmatism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26990","name":"Drainage of pelvis lesion","description":"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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":"L8505","name":"Artificial larynx, accessory","description":"Artificial larynx replacement battery / accessory, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-06-05","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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35537","name":"Art byp grft aortoiliac","description":"Bypass graft, with vein; aortoiliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82608","name":"B-12 binding capacity","description":"Cyanocobalamin (vitamin b-12); unsaturated binding capacity","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33016","name":"Pericardiocentesis w/imaging","description":"Pericardiocentesis, including imaging guidance, when performed","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-06-05","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":"58120","name":"Dilation and curettage","description":"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"25624","name":"Cltx carpl scphd fx w/mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43754","name":"Dx gastr intub w/asp spec","description":"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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":"C1894","name":"Intro/sheath, non-laser","description":"Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"32602","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-06-05","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":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57284","name":"Repair paravag defect open","description":"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-06-05","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":"10180","name":"I&d complex po wound infctj","description":"Incision and drainage, complex, postoperative wound infection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35693","name":"Art trnsposj subclavian","description":"Transposition and/or reimplantation; vertebral to subclavian artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4290","name":"Sacral nerve stim test lead","description":"Sacral nerve stimulation test lead, each","date_of_service":"2026-06-05","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":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50340","name":"Recipient nephrectomy","description":"Recipient nephrectomy (separate procedure)","date_of_service":"2026-06-05","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-06-05","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":"43331","name":"Esophagomyotomy thoracic","description":"Esophagomyotomy (heller type); thoracic approach","date_of_service":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-06-05","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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-06-05","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-06-05","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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-05","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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33926","name":"Repr pul art unifocal w/cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"48105","name":"Resect/debride pancreas","description":"Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","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":"L3320","name":"Shoe lift elev heel/sole cor","description":"Lift, elevation, heel and sole, cork, per inch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21198","name":"Reconstr lwr jaw segment","description":"Osteotomy, mandible, segmental;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-06-05","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":"27508","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, without manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99324","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81020","name":"Urinalysis glass test","description":"Urinalysis; 2 or 3 glass test","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L3204","name":"Hightop w/ supp/pronator inf","description":"Orthopedic shoe, hightop with supinator or pronator, infant","date_of_service":"2026-06-05","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":"54437","name":"Repair corporeal tear","description":"Repair of traumatic corporeal tear(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99325","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"95831","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-05","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":"G0394","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84702","name":"Chorionic gonadotropin test","description":"Gonadotropin, chorionic (hcg); quantitative","date_of_service":"2026-06-05","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":"94360","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15793","name":"Chemical peel nonfacial drm","description":"Chemical peel, nonfacial; dermal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-06-05","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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-06-05","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":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45112","name":"Removal of rectum","description":"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)","date_of_service":"2026-06-05","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":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-06-05","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":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-06-05","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":"G0393","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-05","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":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67901","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-06-05","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":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44390","name":"Colonoscopy for foreign body","description":"Colonoscopy through stoma; with removal of foreign body(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","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":["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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-06-05","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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"69205","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; with general anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"56820","name":"Colposcopy vulva","description":"Colposcopy of the vulva;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-06-05","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":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0464","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33692","name":"Comp rpr tof wo pulm atresia","description":"Complete repair tetralogy of fallot without pulmonary atresia;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-06-05","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":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"15826","name":"Rhytidectomy glblr frn lines","description":"Rhytidectomy; glabellar frown lines","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-05","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":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-06-05","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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-05","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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"29730","name":"Windowing of cast","description":"Windowing of cast","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27427","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; extra-articular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82145","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93532","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-06-05","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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0115","name":"Post-coital mucous exam","description":"Post-coital direct, qualitative examinations of vaginal or cervical mucous","date_of_service":"2026-06-05","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":"63196","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33460","name":"Revision of tricuspid valve","description":"Valvectomy, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21246","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0247","name":"Trans bench w/wo comm open","description":"Transfer bench for tub or toilet with or without commode opening","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50398","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-06-05","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":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27700","name":"Revision of ankle joint","description":"Arthroplasty, ankle;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"22526","name":"Idet single level","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84702","name":"Chorionic gonadotropin test","description":"Gonadotropin, chorionic (hcg); quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-06-05","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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26785","name":"Treat finger dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75952","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"27645","name":"Resect tibia tumor","description":"Radical resection of tumor; tibia","date_of_service":"2026-06-05","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":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["11004","11005","11101","11102","11103","11104","11105","11106","11109","11120","11351","11352","11354","11355","11356","11357","11358","11359","11360","11361","11362","11363","11364","11365","11366","11367","11368","11369","11370","11371","11372","11373","11374","11375","11377","11378","11379","11380","11381","11385","11386","11390","11405","11411","11412","11413","11414","11415","11416","11417","11418","11419","11420","11421","11422","11423","11424","11425","11426","11427","11428","11429","11430","11431","11432","11433","11434","11435","11436","11437","11439","11451","11499","11690","11691","11692","11693","11694","11695","11697"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83045","name":"Hgb methemoglobin qual","description":"Hemoglobin; methemoglobin, qualitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"37223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4542","name":"Small disposable underpad","description":"Incontinence product, disposable underpad, small size, each","date_of_service":"2026-06-05","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":"35523","name":"Art byp grft brchl-ulnr-rdl","description":"Bypass graft, with vein; brachial-ulnar or -radial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43621","name":"Removal of stomach","description":"Gastrectomy, total; with roux-en-y reconstruction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"37210","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"57156","name":"Ins vag brachytx device","description":"Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0710","name":"Restraints any type","description":"Restraints, any type (body, chest, wrist or ankle)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58823","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93527","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"0190T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-05","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":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-06-05","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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36514","name":"Apheresis plasma","description":"Therapeutic apheresis; for plasma pheresis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83897","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67801","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, same lid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36838","name":"Dist revas ligation hemo","description":"Distal revascularization and interval ligation (dril), upper extremity hemodialysis access (steal syndrome)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-06-05","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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52305","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"17340","name":"Cryotherapy for acne","description":"Cryotherapy (co2 slush, liquid n2) for acne","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-06-05","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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","21","31","49","02","65","81","32","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":"2026-06-05","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":"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":"2026-06-05","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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-06-05","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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-06-05","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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-06-05","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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50060","name":"Nl removal calculus","description":"Nephrolithotomy; removal of calculus","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61612","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","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":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-06-05","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":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-06-05","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":"68360","name":"Revise eyelid lining","description":"Conjunctival flap; bridge or partial (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-06-05","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":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49402","name":"Remove foreign body adbomen","description":"Removal of peritoneal foreign body from peritoneal cavity","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-06-05","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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0074A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36870","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-05","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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","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":"L3911","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-06-05","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0209T","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold), automated; air and bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88386","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-06-05","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":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-06-05","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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-06-05","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":"89055","name":"Leukocyte assessment fecal","description":"Leukocyte assessment, fecal, qualitative or semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-06-05","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":"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 observ","date_of_service":"2026-06-05","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":["66","02","81","32","13","56","31","06","51","61","07","19","05","23","41","21","26","49","52","65","42","24","22","33","10","08","53","34","18"],"billing_code_modifier":["93","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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-06-05","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L3909","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4931","name":"Reusable oral thermometer","description":"Oral thermometer, reusable, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84560","name":"Assay of urine/uric acid","description":"Uric acid; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-06-05","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":"46706","name":"Repr of anal fistula w/glue","description":"Repair of anal fistula with fibrin glue","date_of_service":"2026-06-05","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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26492","name":"Tendon transfer with graft","description":"Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1769","name":"Guide wire","description":"Guide wire","date_of_service":"2026-06-05","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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5008","name":"Hearing screening","description":"Hearing screening","date_of_service":"2026-06-05","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":"26035","name":"Decompress fingers/hand","description":"Decompression fingers and/or hand, injection injury (eg, grease gun)","date_of_service":"2026-06-05","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":"28008","name":"Incision of foot fascia","description":"Fasciotomy, foot and/or toe","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"69530","name":"Extensive mastoid surgery","description":"Petrous apicectomy including radical mastoidectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-05","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":"66852","name":"Removal of lens material","description":"Removal of lens material; pars plana approach, with or without vitrectomy","date_of_service":"2026-06-05","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":"15340","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-06-05","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":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-06-05","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":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-06-05","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":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84030","name":"Assay of blood pku","description":"Phenylalanine (pku), blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-06-05","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77522","name":"Proton trmt simple w/comp","description":"Proton treatment delivery; simple, with compensation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45327","name":"Proctosigmoidoscopy w/stent","description":"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-06-05","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":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4522","name":"Adult size brief/diaper med","description":"Adult sized disposable incontinence product, brief/diaper, medium, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"69436","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), general anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49655","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35800","name":"Explore neck vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15830","name":"Exc excessive skin abdomen","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-06-05","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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-06-05","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":"33231","name":"Insrt pulse gen w/mult leads","description":"Insertion of implantable defibrillator pulse generator only; with existing multiple leads","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25924","name":"Amputation follow-up surgery","description":"Disarticulation through wrist; re-amputation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53855","name":"Insert prost urethral stent","description":"Insertion of a temporary prostatic urethral stent, including urethral measurement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36818","name":"Av fuse uppr arm cephalic","description":"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-06-05","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":"90821","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85240","name":"Clot factor viii ahg 1 stage","description":"Clotting; factor viii (ahg), 1-stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42720","name":"I&d absc phrngl ntraorl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-06-05","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":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["CSTM-00"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3208","name":"Surgical boot each infant","description":"Surgical boot, each, infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"15040","name":"Harvest cultured skin graft","description":"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less","date_of_service":"2026-06-05","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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-06-05","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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28086","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; flexor","date_of_service":"2026-06-05","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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-06-05","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":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0501T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-05","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":"61524","name":"Removal of brain lesion","description":"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87495","name":"Cytomeg dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, direct probe technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU"]}],"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":"2026-06-05","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":"78220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"42100","name":"Biopsy roof of mouth","description":"Biopsy of palate, uvula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-06-05","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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-06-05","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":"A4261","name":"Cervical cap contraceptive","description":"Cervical cap for contraceptive use","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31591","name":"Laryngoplasty medialization","description":"Laryngoplasty, medialization, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63273","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15931","name":"Exc sacral pr ulc prim sutr","description":"Excision, sacral pressure ulcer, with primary suture;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85300","name":"Antithrombin iii activity","description":"Clotting inhibitors or anticoagulants; antithrombin iii, activity","date_of_service":"2026-06-05","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":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-06-05","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":"15421","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"54220","name":"Irrg crpra cavrnosa priapism","description":"Irrigation of corpora cavernosa for priapism","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-06-05","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":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50240","name":"Nephrectomy partial","description":"Nephrectomy, partial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86060","name":"Antistreptolysin o titer","description":"Antistreptolysin 0; titer","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42280","name":"Preparation palate mold","description":"Maxillary impression for palatal prosthesis","date_of_service":"2026-06-05","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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"65286","name":"Repair of eye wound","description":"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90815","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27610","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"99225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95936","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3221","name":"Orthopedic mens shoes dpth i","description":"Orthopedic footwear, mens shoe, depth inlay, each","date_of_service":"2026-06-05","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":"61558","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts","date_of_service":"2026-06-05","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":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-06-05","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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85525","name":"Heparin neutralization","description":"Heparin neutralization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"36861","name":"Cannula declotting","description":"External cannula declotting (separate procedure); with balloon catheter","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31085","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-06-05","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":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57550","name":"Removal of residual cervix","description":"Excision of cervical stump, vaginal approach;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86337","name":"Insulin antibodies","description":"Insulin antibodies","date_of_service":"2026-06-05","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":"43281","name":"Lap paraesophag hern repair","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35321","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; axillary-brachial","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15828","name":"Rhytidectomy cheek chn & nck","description":"Rhytidectomy; cheek, chin, and neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-06-05","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":"0499T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-06-05","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":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87808","name":"Trichomonas assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; trichomonas vaginalis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61140","name":"Burr hole/treph bx brain/les","description":"Burr hole(s) or trephine; with biopsy of brain or intracranial lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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":["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":"2026-06-05","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":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-06-05","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":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-06-05","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":"60225","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36005","name":"Injection ext venography","description":"Injection procedure for extremity venography (including introduction of needle or intracatheter)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-06-05","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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-05","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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-06-05","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":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-06-05","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":"54055","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"62318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-05","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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55870","name":"Electroejaculation","description":"Electroejaculation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-06-05","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":"95831","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"0209T","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold), automated; air and bone","date_of_service":"2026-06-05","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"19112","name":"Excise breast duct fistula","description":"Excision of lactiferous duct fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-06-05","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":"57110","name":"Vagnc compl rmvl vag wall","description":"Vaginectomy, complete removal of vaginal wall;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25820","name":"Arthrd wrist lmtd w/o b1 grf","description":"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77786","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-05","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":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78588","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-06-05","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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77787","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-05","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":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"93721","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90818","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"86744","name":"Nocardia antibody","description":"Antibody; nocardia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87279","name":"Parainfluenza ag if","description":"Infectious agent antigen detection by immunofluorescent technique; parainfluenza virus, each type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74305","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64476","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32852","name":"Lung transplant with bypass","description":"Lung transplant, single; with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86243","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59130","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; abdominal pregnancy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29895","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29847","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; internal fixation for fracture or instability","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33884","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25805","name":"Arthrd wrist w/sliding graft","description":"Arthrodesis, wrist; with sliding graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"36500","name":"Insertion of catheter vein","description":"Venous catheterization for selective organ blood sampling","date_of_service":"2026-06-05","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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-05","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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-06-05","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":"24600","name":"Tx clsd elbow dislc w/o anes","description":"Treatment of closed elbow dislocation; without anesthesia","date_of_service":"2026-06-05","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":"15931","name":"Exc sacral pr ulc prim sutr","description":"Excision, sacral pressure ulcer, with primary suture;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"67700","name":"Blepharotomy drg absc eyelid","description":"Blepharotomy, drainage of abscess, eyelid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-06-05","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":"86903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"51102","name":"Drain bl w/cath insertion","description":"Aspiration of bladder; with insertion of suprapubic catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-06-05","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":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50820","name":"Construct bowel bladder","description":"Ureteroileal conduit (ileal bladder), including intestine anastomosis (bricker operation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-06-05","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92981","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-06-05","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80152","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"92358","name":"Aphakia prosth service temp","description":"Prosthesis service for aphakia, temporary (disposable or loan, including materials)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53235","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); male","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67911","name":"Revise eyelid defect","description":"Correction of lid retraction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87086","name":"Urine culture/colony count","description":"Culture, bacterial; quantitative colony count, urine","date_of_service":"2026-06-05","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":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"T4534","name":"Youth size pull-on","description":"Youth sized disposable incontinence product, protective underwear/pull-on, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-06-05","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":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0064A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10001","10002","10003","10004","10005","10006","10007","10008","10009","10010","10011","10012","10013","10014","10015","10016","10017","10018","10019","10020","10021","10022","10023","10024","10025","10026","10027","10028","10029","10030","10031","10032","10033","10034","10035","10036","10037","10038","10039","10040","10041","10043","10044","10045","10046","10047","10048","10055","10060","10065","10069","10072","10075","10079","10080","10081","10082","10087","10090","10094","10095","10096","10098","10099","10101","10102","10103","10104","10105","10106","10107","10108","10109","10110","10111","10112","10113","10114","10115","10116","10117","10118","10119","10120","10121","10122","10123","10124","10125","10126","10128","10129","10130","10131","10132","10133","10138","10149","10150","10151","10152","10153","10154","10155","10156","10157","10158","10159","10160","10161","10162","10163","10164","10165","10166","10167","10168","10169","10170","10171","10172","10173","10174","10175","10176","10177","10178","10179","10184","10185","10196","10197","10199","10203","10211","10212","10213","10242","10249","10256","10257","10258","10259","10260","10261","10265","10268","10269","10270","10271","10272","10273","10274","10275","10276","10277","10278","10279","10280","10281","10282","10285","10286","10292"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69905","name":"Remove inner ear","description":"Labyrinthectomy; transcanal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-06-05","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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"76496","name":"Unlisted fluoroscopic px","description":"Unlisted fluoroscopic procedure (eg, diagnostic, interventional)","date_of_service":"2026-06-05","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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-06-05","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":"21461","name":"Optx mndblr fx wo ntrdntl","description":"Open treatment of mandibular fracture; without interdental fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37140","name":"Revision of circulation","description":"Venous anastomosis, open; portocaval","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82979","name":"Assay rbc glutathione","description":"Glutathione reductase, rbc","date_of_service":"2026-06-05","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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-06-05","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":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43285","name":"Rmvl esophgl sphnctr dev","description":"Removal of esophageal sphincter augmentation device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-06-05","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":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-06-05","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":"26992","name":"Drainage of bone lesion","description":"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"57425","name":"Laparoscopy surg colpopexy","description":"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85290","name":"Clot factor xiii fibrin stab","description":"Clotting; factor xiii (fibrin stabilizing)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"43101","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28531","name":"Treat sesamoid bone fracture","description":"Open treatment of sesamoid fracture, with or without internal fixation","date_of_service":"2026-06-05","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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27185","name":"Revision of femur epiphysis","description":"Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","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":"23030","name":"I&d shoulder deep absc/hmtma","description":"Incision and drainage, shoulder area; deep abscess or hematoma","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-05","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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23462","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with coracoid process transfer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51700","name":"Irrigation of bladder","description":"Bladder irrigation, simple, lavage and/or instillation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0457","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-05","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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-06-05","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":"33976","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"67112","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96111","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83498","name":"Asy hydroxyprogesterone 17-d","description":"Hydroxyprogesterone, 17-d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75662","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-05","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":"E0243","name":"Toilet rail","description":"Toilet rail, each","date_of_service":"2026-06-05","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":"62267","name":"Interdiscal perq aspir dx","description":"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35523","name":"Art byp grft brchl-ulnr-rdl","description":"Bypass graft, with vein; brachial-ulnar or -radial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-06-05","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":"15331","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-05","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":"75558","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-06-05","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":"92533","name":"Caloric vestibular test","description":"Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-06-05","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":"89141","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-06-05","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":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4709","name":"Acid conc sol per gallon","description":"Acid concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-06-05","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":"50970","name":"Ureter endoscopy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99219","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"41805","name":"Removal foreign body gum","description":"Removal of embedded foreign body from dentoalveolar structures; soft tissues","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46900","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45135","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"24140","name":"Partial exc bone humerus","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43771","name":"Lap revise gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device component only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86707","name":"Hepatitis be antibody","description":"Hepatitis be antibody (hbeab)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84583","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; semiquantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"42820","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; younger than age 12","date_of_service":"2026-06-05","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":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-06-05","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":"26615","name":"Treat metacarpal fracture","description":"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75662","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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":"0290T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-06-05","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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86788","name":"West nile virus ab igm","description":"Antibody; west nile virus, igm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"89331","name":"Retrograde ejaculation anal","description":"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82360","name":"Calculus assay quant","description":"Calculus; quantitative analysis, chemical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-06-05","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":"31515","name":"Laryngoscopy for aspiration","description":"Laryngoscopy direct, with or without tracheoscopy; for aspiration","date_of_service":"2026-06-05","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":"65785","name":"Impltj ntrstrml crnl rng seg","description":"Implantation of intrastromal corneal ring segments","date_of_service":"2026-06-05","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94662","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15170","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93545","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35570","name":"Art byp tibial-tib/peroneal","description":"Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"93503","name":"Insert/place heart catheter","description":"Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"31800","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; cervical","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L1510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"M0222","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","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":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25112","name":"Reremove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); recurrent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"22522","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61796","name":"Srs cranial lesion simple","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83661","name":"L/s ratio fetal lung","description":"Fetal lung maturity assessment; lecithin sphingomyelin (l/s) ratio","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75993","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"33813","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E8002","name":"Anterior gait trainer","description":"Gait trainer, pediatric size, anterior support, includes all accessories and components","date_of_service":"2026-06-05","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":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L3211","name":"Surgical boot each junior","description":"Surgical boot, each, junior","date_of_service":"2026-06-05","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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92352","name":"Fit aphakia spectcl monofocl","description":"Fitting of spectacle prosthesis for aphakia; monofocal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96152","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-05","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":"32657","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57107","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S0610","name":"Annual gynecological examina","description":"Annual gynecological examination, new patient","date_of_service":"2026-06-05","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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-06-05","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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"49600","name":"Repair umbilical lesion","description":"Repair of small omphalocele, with primary closure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86806","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; without titration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46942","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); subsequent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-06-05","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":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69711","name":"Remove/repair hearing aid","description":"Removal or repair of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"80195","name":"Assay of sirolimus","description":"Sirolimus","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92072","name":"Fitg c-lens keratoconus 1st","description":"Fitting of contact lens for management of keratoconus, initial fitting","date_of_service":"2026-06-05","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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-06-05","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":"61440","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67228","name":"Treatment x10sv retinopathy","description":"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation","date_of_service":"2026-06-05","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":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-06-05","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":"42810","name":"Excision of neck cyst","description":"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-06-05","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":["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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-06-05","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":"23412","name":"Repair rotator cuff chronic","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic","date_of_service":"2026-06-05","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":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29907","name":"Subtalar arthro w/fusion","description":"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"35452","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-06-05","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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23020","name":"Capsular contracture release","description":"Capsular contracture release (eg, sever type procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26670","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33724","name":"Repair venous anomaly","description":"Repair of isolated partial anomalous pulmonary venous return (eg, scimitar syndrome)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"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":"49010","name":"Exploration behind abdomen","description":"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)","date_of_service":"2026-06-05","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":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-06-05","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":"64752","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-06-05","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":"86886","name":"Coombs test indirect titer","description":"Antihuman globulin test (coombs test); indirect, each antibody titer","date_of_service":"2026-06-05","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":"26145","name":"Tendon excision palm/finger","description":"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-06-05","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":"93236","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41108","name":"Biopsy of floor of mouth","description":"Biopsy of floor of mouth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"62165","name":"Remove pituit tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-06-05","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":"62116","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32124","name":"Explore chest free adhesions","description":"Thoracotomy; with open intrapleural pneumonolysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4246","name":"Betadine/phisohex solution","description":"Betadine or phisohex solution, per pint","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"S9152","name":"Speech therapy, re-eval","description":"Speech therapy, re-evaluation","date_of_service":"2026-06-05","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93508","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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 decis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-06-05","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":"61470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"G2065","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77523","name":"Proton trmt intermediate","description":"Proton treatment delivery; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-06-05","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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83903","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95973","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-06-05","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":"37228","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-06-05","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":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92996","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58900","name":"Biopsy of ovary(s)","description":"Biopsy of ovary, unilateral or bilateral (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-06-05","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":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-06-05","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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-06-05","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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"37204","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50546","name":"Laparoscopic nephrectomy","description":"Laparoscopy, surgical; nephrectomy, including partial ureterectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99173","name":"Visual acuity screen","description":"Screening test of visual acuity, quantitative, bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80201","name":"Assay of topiramate","description":"Topiramate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"51900","name":"Repair bladder/vagina lesion","description":"Closure of vesicovaginal fistula, abdominal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-06-05","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":"43320","name":"Fuse esophagus & stomach","description":"Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal or transthoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0298T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64744","name":"Incise nerve back of head","description":"Transection or avulsion of; greater occipital nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"80154","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"B4082","name":"Enteral ng tubing w/o stylet","description":"Nasogastric tubing without stylet","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"26490","name":"Revise thumb tendon","description":"Opponensplasty; superficialis tendon transfer type, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27078","name":"Rsect hip tum incl femur","description":"Radical resection of tumor; ischial tuberosity and greater trochanter of femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15941","name":"Exc isch pr ulc prm sut ostc","description":"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43219","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35539","name":"Art byp grft aortofemoral","description":"Bypass graft, with vein; aortofemoral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-06-05","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":"80176","name":"Assay of lidocaine","description":"Lidocaine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"21081","name":"Impres&prep mndbl res prosth","description":"Impression and custom preparation; mandibular resection prosthesis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61315","name":"Crnec/crnot ittl ntracereblr","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21208","name":"Augmentation of facial bones","description":"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)","date_of_service":"2026-06-05","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31588","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35481","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42802","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36593","name":"Declot vascular device","description":"Declotting by thrombolytic agent of implanted vascular access device or catheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"65782","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0027","name":"Semen analysis","description":"Semen analysis; presence and/or motility of sperm excluding huhner","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"41500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-06-05","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"23520","name":"Cltx strnclav dislc w/o mnpj","description":"Closed treatment of sternoclavicular dislocation; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4267","name":"Male condom","description":"Contraceptive supply, condom, male, each","date_of_service":"2026-06-05","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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"27603","name":"Drain lower leg lesion","description":"Incision and drainage, leg or ankle; deep abscess or hematoma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","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":"33234","name":"Removal of pacemaker system","description":"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75680","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-06-05","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0466T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21750","name":"Repair of sternum separation","description":"Closure of median sternotomy separation with or without debridement (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44397","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54056","name":"Cryosurgery penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-06-05","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":"C2617","name":"Stent, non-cor, tem w/o del","description":"Stent, non-coronary, temporary, without delivery system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-06-05","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":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"36810","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (scribner type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37222","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45383","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84560","name":"Assay of urine/uric acid","description":"Uric acid; other source","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-06-05","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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"58940","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","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":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84591","name":"Assay of nos vitamin","description":"Vitamin, not otherwise specified","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-06-05","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":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-06-05","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":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-06-05","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":"49590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L1825","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"29902","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, stener lesion)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-06-05","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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-06-05","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":"L3700","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"Q4031","name":"Cast sup lng leg ped plaster","description":"Cast supplies, long leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"62303","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; thoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"34805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-05","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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28119","name":"Removal of heel spur","description":"Ostectomy, calcaneus; for spur, with or without plantar fascial release","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64412","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-06-05","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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"94770","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41825","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88329","name":"Path consltj drg surg","description":"Pathology consultation during surgery;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27607","name":"Treat lower leg bone lesion","description":"Incision (eg, osteomyelitis or bone abscess), leg or ankle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53440","name":"Male sling procedure","description":"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"B4164","name":"Parenteral 50% dextrose solu","description":"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix","date_of_service":"2026-06-05","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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-06-05","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":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28735","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28062","name":"Removal of foot fascia","description":"Fasciectomy, plantar fascia; radical (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"89325","name":"Sperm antibody test","description":"Sperm antibodies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-05","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":"15365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0013A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-06-05","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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-06-05","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":"93556","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-06-05","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":"58293","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-06-05","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":"55450","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26497","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; ring and small finger","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"49505","name":"Prp i/hern init reduc >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; reducible","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"38211","name":"Tumor cell deplete of harvst","description":"Transplant preparation of hematopoietic progenitor cells; tumor cell depletion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"31525","name":"Dx laryngoscopy excl nb","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["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":"2026-06-05","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":"75889","name":"Vein x-ray liver w/hemodynam","description":"Hepatic venography, wedged or free, with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4365","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-06-05","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":"33406","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78460","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96154","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44661","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; with intestine and/or bladder resection","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-06-05","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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"0308T","name":"Insj ocular telescope prosth","description":"Insertion of ocular telescope prosthesis including removal of crystalline lens or intraocular lens prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0145T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-06-05","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":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-06-05","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":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-06-05","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":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"90466","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27641","name":"Partial removal of fibula","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula","date_of_service":"2026-06-05","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":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"38760","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, including cloquets node (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-06-05","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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-06-05","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":"35522","name":"Art byp grft axill-brachial","description":"Bypass graft, with vein; axillary-brachial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"B4180","name":"Parenteral sol carb > 50%","description":"Parenteral nutrition solution; carbohydrates (dextrose), greater than 50% (500 ml = 1 unit) - home mix","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37203","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"30115","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0437","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33535","name":"Cabg arterial three","description":"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts","date_of_service":"2026-06-05","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":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"2026-06-05","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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"95010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26685","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-06-05","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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-05","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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27550","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; without anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"25445","name":"Arthrp w/prostc trapezium","description":"Arthroplasty with prosthetic replacement; trapezium","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15951","name":"Exc trchntr pr ulc ostc","description":"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4641","name":"Radiopharm dx agent noc","description":"Radiopharmaceutical, diagnostic, not otherwise classified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95979","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-06-05","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":"63198","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85460","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; differential lysis (kleihauer-betke)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84403","name":"Assay of total testosterone","description":"Testosterone; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83788","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"20962","name":"Other bone graft microvasc","description":"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4510","name":"Full length surg stocking","description":"Surgical stockings full length, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"M0245","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33231","name":"Insrt pulse gen w/mult leads","description":"Insertion of implantable defibrillator pulse generator only; with existing multiple leads","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-05","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":"61542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61875","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-06-05","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":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-06-05","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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28636","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95833","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"35241","name":"Rpr blvsl vn grf ntrthrc w/b","description":"Repair blood vessel with vein graft; intrathoracic, with bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28140","name":"Removal of metatarsal","description":"Metatarsectomy","date_of_service":"2026-06-05","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":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44202","name":"Lap enterectomy","description":"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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","AU","AV","93"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-06-05","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":"37251","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87661","name":"Trichomonas vaginalis amplif","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, amplified probe technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"27726","name":"Repair fibula nonunion","description":"Repair of fibula nonunion and/or malunion with internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61548","name":"Removal of pituitary gland","description":"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27194","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"45400","name":"Laparoscopic proc","description":"Laparoscopy, surgical; proctopexy (for prolapse)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-06-05","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":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-06-05","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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-06-05","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":"L4002","name":"Replace strap, any orthosis","description":"Replacement strap, any orthosis, includes all components, any length, any type","date_of_service":"2026-06-05","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":"99420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"99328","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-06-05","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":"27437","name":"Revise kneecap","description":"Arthroplasty, patella; without prosthesis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47720","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; direct","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57545","name":"Remove cervix/repair pelvis","description":"Excision of cervical stump, abdominal approach; with pelvic floor repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78478","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99334","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-06-05","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":"82638","name":"Assay of dibucaine number","description":"Dibucaine number","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-06-05","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":"34803","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25651","name":"Perq skel fix ulnar styld fx","description":"Percutaneous skeletal fixation of ulnar styloid fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43331","name":"Esophagomyotomy thoracic","description":"Esophagomyotomy (heller type); thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4911","name":"Drain bag/bottle","description":"Drain bag/bottle, for dialysis, each","date_of_service":"2026-06-05","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":"46930","name":"Destroy internal hemorrhoids","description":"Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared coagulation, cautery, radiofrequency)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42836","name":"Removal of adenoids","description":"Adenoidectomy, secondary; age 12 or over","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"68371","name":"Harvest eye tissue alograft","description":"Harvesting conjunctival allograft, living donor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"0044A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46735","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42320","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary, external","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78271","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"15775","name":"Hair trnspl 1-15 punch grfts","description":"Punch graft for hair transplant; 1 to 15 punch grafts","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-06-05","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":"L3219","name":"Orthopedic mens shoes oxford","description":"Orthopedic footwear, mens shoe, oxford, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43326","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86711","name":"John cunningham antibody","description":"Antibody; jc (john cunningham) virus","date_of_service":"2026-06-05","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":"63180","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28730","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64600","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"67917","name":"Repair eyelid defect","description":"Repair of ectropion; extensive (eg, tarsal strip operations)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"G0455","name":"Fecal microbiota prep instil","description":"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23470","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; hemiarthroplasty","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-06-05","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":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4224","name":"Parenteral administration ki","description":"Parenteral nutrition administration kit, per day","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4719","name":"Y set tubing","description":"Y set tubing for peritoneal dialysis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31530","name":"Laryngoscopy w/fb removal","description":"Laryngoscopy, direct, operative, with foreign body removal;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"27325","name":"Neurectomy hamstring","description":"Neurectomy, hamstring muscle","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86713","name":"Legionella antibody","description":"Antibody; legionella","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82136","name":"Amino acids quant 2-5","description":"Amino acids, 2 to 5 amino acids, quantitative, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"34800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-06-05","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-06-05","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":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-06-05","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":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"90817","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15171","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-06-05","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":"C1753","name":"Cath, intravas ultrasound","description":"Catheter, intravascular ultrasound","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-06-05","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":"49520","name":"Rerepair ing hernia reduce","description":"Repair recurrent inguinal hernia, any age; reducible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"60520","name":"Removal of thymus gland","description":"Thymectomy, partial or total; transcervical approach (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-06-05","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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-06-05","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":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-06-05","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":"19272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33475","name":"Replacement pulmonary valve","description":"Replacement, pulmonary valve","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-06-05","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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"22525","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-06-05","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":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-06-05","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":"32402","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-06-05","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-05","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-05","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":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19290","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"37250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27134","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; both components, with or without autograft or allograft","date_of_service":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37232","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"01190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"53260","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral polyp(s), distal urethra","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19370","name":"Revj peri-implt capsule brst","description":"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26850","name":"Fusion of knuckle","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78465","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27659","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-06-05","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":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0503","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-06-05","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":"29915","name":"Hip arthro acetabuloplasty","description":"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26536","name":"Revise/implant finger joint","description":"Arthroplasty, interphalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"Q4099","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57268","name":"Repair of bowel bulge","description":"Repair of enterocele, vaginal approach (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75960","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49525","name":"Repair ing hernia sliding","description":"Repair inguinal hernia, sliding, any age","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84484","name":"Assay of troponin quant","description":"Troponin, quantitative","date_of_service":"2026-06-05","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":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28475","name":"Cltx metatarsal fx w/mnpj ea","description":"Closed treatment of metatarsal fracture; with manipulation, each","date_of_service":"2026-06-05","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":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"77385","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"FacilityZip","value":["10509","10512","10516","10524","10537","10541","10542","10579","10910","10912","10914","10915","10916","10917","10918","10919","10921","10922","10924","10925","10926","10928","10930","10932","10933","10940","10941","10943","10949","10950","10953","10958","10959","10963","10969","10973","10975","10979","10981","10985","10987","10988","10990","10992","10996","10997","10998","12015","12017","12029","12037","12042","12050","12051","12058","12060","12075","12083","12087","12106","12115","12124","12125","12130","12132","12136","12165","12167","12172","12173","12174","12176","12184","12192","12195","12401","12402","12404","12405","12406","12407","12409","12410","12411","12412","12413","12414","12416","12417","12418","12419","12420","12421","12422","12423","12424","12427","12428","12429","12430","12431","12432","12433","12434","12435","12436","12438","12439","12440","12441","12442","12443","12444","12446","12448","12449","12450","12451","12452","12453","12454","12455","12456","12457","12458","12459","12460","12461","12463","12464","12465","12466","12468","12470","12471","12472","12473","12474","12475","12477","12480","12481","12482","12483","12484","12485","12486","12487","12489","12490","12491","12492","12493","12494","12495","12496","12498","12501","12502","12503","12504","12506","12507","12508","12510","12511","12512","12513","12514","12515","12516","12517","12518","12520","12521","12522","12523","12524","12525","12526","12527","12528","12529","12530","12531","12533","12534","12537","12538","12540","12541","12542","12543","12544","12545","12546","12547","12548","12549","12550","12551","12552","12553","12555","12561","12563","12564","12565","12566","12567","12568","12569","12570","12571","12572","12574","12575","12577","12578","12580","12581","12582","12583","12584","12585","12586","12588","12589","12590","12592","12593","12594","12601","12602","12603","12604","12701","12719","12720","12721","12722","12723","12724","12725","12726","12727","12729","12732","12733","12734","12736","12737","12738","12740","12741","12742","12743","12745","12746","12747","12748","12749","12750","12751","12752","12754","12758","12759","12760","12762","12763","12764","12765","12766","12767","12768","12769","12770","12771","12775","12776","12777","12778","12779","12780","12781","12782","12783","12784","12785","12786","12787","12788","12789","12790","12791","12792","13731","13739","13740","13750","13751","13752","13753","13755","13756","13757","13774","13775","13782","13783","13786","13788","13804","13806","13837","13838","13839","13842","13846","13847","13856","13860"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.72,"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":"74475","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-06-05","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23174","name":"Sqstrctmy humrl head srg nck","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"93982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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":"0355T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31255","name":"Nsl/sins ndsc w/tot ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-06-05","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":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"89125","name":"Specimen fat stain","description":"Fat stain, feces, urine, or respiratory secretions","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-06-05","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":"35508","name":"Art byp grft carotid-vertbrl","description":"Bypass graft, with vein; carotid-vertebral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"62284","name":"Injection for myelogram","description":"Injection procedure for myelography and/or computed tomography, lumbar","date_of_service":"2026-06-05","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":"40831","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; over 2.5 cm or complex","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60212","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86378","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-06-05","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":"60240","name":"Removal of thyroid","description":"Thyroidectomy, total or complete","date_of_service":"2026-06-05","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":"43258","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","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":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-06-05","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":"L2860","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"37230","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01935","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3201","name":"Oxford w supinat/pronat inf","description":"Orthopedic shoe, oxford with supinator or pronator, infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"37616","name":"Ligation major artery chest","description":"Ligation, major artery (eg, post-traumatic, rupture); chest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86376","name":"Microsomal antibody each","description":"Microsomal antibodies (eg, thyroid or liver-kidney), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-06-05","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":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-06-05","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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3255","name":"Orth foot non-standard size/","description":"Non-standard size or length","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-06-05","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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-05","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":"33427","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67912","name":"Correction eyelid w/implant","description":"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-06-05","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":"42808","name":"Excise pharynx lesion","description":"Excision or destruction of lesion of pharynx, any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90911","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92371","name":"Rpr&refit spct prsth aphakia","description":"Repair and refitting spectacles; spectacle prosthesis for aphakia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-06-05","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":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-06-05","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62360","name":"Insert spine infusion device","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-05","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":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-06-05","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":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0434","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35634","name":"Bpg iliorenal","description":"Bypass graft, with other than vein; iliorenal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-06-05","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":"29835","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, partial","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46762","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-06-05","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"46260","name":"Remove in/ex hem groups 2+","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84704","name":"Hcg free betachain test","description":"Gonadotropin, chorionic (hcg); free beta chain","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","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":["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":"2026-06-05","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":"25301","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; extensors of fingers","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61512","name":"Crnec treph exc mngioma sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-06-05","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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"43262","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"27598","name":"Amputate lower leg at knee","description":"Disarticulation at knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92569","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-06-05","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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-06-05","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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99336","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-06-05","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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-06-05","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-06-05","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":["CSTM-00"],"billing_code_modifier":["NU",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"47701","name":"Bile duct revision","description":"Portoenterostomy (eg, kasai procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29010","name":"Appl risser jacket body only","description":"Application of risser jacket, localizer, body; only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15330","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54360","name":"Penis plastic surgery","description":"Plastic operation on penis to correct angulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27165","name":"Incision/fixation of femur","description":"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-06-05","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":"65760","name":"Keratomileusis","description":"Keratomileusis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-06-05","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":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62143","name":"Rpl b1 flp/prostc plate skl","description":"Replacement of bone flap or prosthetic plate of skull","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21026","name":"Excision of facial bone(s)","description":"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)","date_of_service":"2026-06-05","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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11102","name":"Tangntl bx skin single les","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion","date_of_service":"2026-06-05","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":"43831","name":"Gastrostomy open neonatal","description":"Gastrostomy, open; neonatal, for feeding","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-06-05","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9500","name":"Tc99m sestamibi","description":"Technetium tc-99m sestamibi, diagnostic, per study dose","date_of_service":"2026-06-05","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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"25685","name":"Optx trns-scphprlnr fx dislc","description":"Open treatment of trans-scaphoperilunar type of fracture dislocation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-06-05","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":"27138","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; femoral component only, with or without allograft","date_of_service":"2026-06-05","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":"78591","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-06-05","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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-05","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":"82975","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-06-05","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":"24006","name":"Arthrt elbw capsl exc rls","description":"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87277","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"61480","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L1800","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E8000","name":"Posterior gait trainer","description":"Gait trainer, pediatric size, posterior support, includes all accessories and components","date_of_service":"2026-06-05","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":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21385","name":"Opn tx orbit fx transantral","description":"Open treatment of orbital floor blowout fracture; transantral approach (caldwell-luc type operation)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-06-05","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":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"43256","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21616","name":"Exc 1st&/crv rib w/sympth","description":"Excision first and/or cervical rib; with sympathectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33286","name":"Rmvl subq car rhythm mntr","description":"Removal, subcutaneous cardiac rhythm monitor","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-06-05","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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-06-05","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84583","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; semiquantitative","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86709","name":"Hepatitis a igm antibody","description":"Hepatitis a antibody (haab), igm antibody","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"33216","name":"Insert 1 electrode pm-defib","description":"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27110","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to greater trochanter of femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-06-05","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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-06-05","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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-06-05","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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"94260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84210","name":"Assay of pyruvate","description":"Pyruvate","date_of_service":"2026-06-05","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-06-05","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":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37225","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"15782","name":"Dermabrasion other than face","description":"Dermabrasion; regional, other than face","date_of_service":"2026-06-05","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":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53661","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; subsequent","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-06-05","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":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3672","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"28300","name":"Incision of heel bone","description":"Osteotomy; calcaneus (eg, dwyer or chambers type procedure), with or without internal fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-06-05","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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-06-05","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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-06-05","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":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-06-05","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-06-05","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":"82690","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-06-05","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":"77031","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77083","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-06-05","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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-06-05","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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-06-05","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":"21407","name":"Opn tx orbit fx w/implant","description":"Open treatment of fracture of orbit, except blowout; with implant","date_of_service":"2026-06-05","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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","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":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-06-05","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":"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 indiv","date_of_service":"2026-06-05","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":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"64865","name":"Repair of facial nerve","description":"Suture of facial nerve; infratemporal, with or without grafting","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35638","name":"Bpg aortobi-iliac","description":"Bypass graft, with other than vein; aortobi-iliac","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52325","name":"Cystoscopy stone removal","description":"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)","date_of_service":"2026-06-05","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":"54660","name":"Revision of testis","description":"Insertion of testicular prosthesis (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21820","name":"Treat sternum fracture","description":"Closed treatment of sternum fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-06-05","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":"G2058","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","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":"B4087","name":"Gastro/jejuno tube, std","description":"Gastrostomy/jejunostomy tube, standard, any material, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90791","name":"Psych diagnostic evaluation","description":"Psychiatric diagnostic evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","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":"26500","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-06-05","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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33860","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"56637","name":"Vlvctmy rad comp bi lymphad","description":"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28003","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas","date_of_service":"2026-06-05","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":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-06-05","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":"A4305","name":"Drug delivery system >=50 ml","description":"Disposable drug delivery system, flow rate of 50 ml or greater per hour","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19105","name":"Cryosurg ablate fa each","description":"Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95978","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82610","name":"Cystatin c","description":"Cystatin c","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-06-05","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":"23921","name":"Disarticulation sho sec clsr","description":"Disarticulation of shoulder; secondary closure or scar revision","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-06-05","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0337","name":"Hospice evaluation preelecti","description":"Hospice evaluation and counseling services, pre-election","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94770","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-05","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-06-05","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":"48547","name":"Duodenal exclusion","description":"Duodenal exclusion with gastrojejunostomy for pancreatic injury","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33534","name":"Cabg arterial two","description":"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6583","name":"Grad com wrap w straps bk","description":"Gradient compression wrap with adjustable straps, below knee, each","date_of_service":"2026-06-05","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":"62010","name":"Treatment of head injury","description":"Elevation of depressed skull fracture; with repair of dura and/or debridement of brain","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75790","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-06-05","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":"39400","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-06-05","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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-06-05","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-06-05","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":"31770","name":"Repair/graft of bronchus","description":"Bronchoplasty; graft repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-06-05","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"M0220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"S8265","name":"Haberman feeder","description":"Haberman feeder for cleft lip/palate","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92590","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37221","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"28825","name":"Partial amputation of toe","description":"Amputation, toe; interphalangeal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4663","name":"Dialysis blood pressure cuff","description":"Blood pressure cuff only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15734","name":"Muscle-skin graft trunk","description":"Muscle, myocutaneous, or fasciocutaneous flap; trunk","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86870","name":"Rbc antibody identification","description":"Antibody identification, rbc antibodies, each panel for each serum technique","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"89135","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63270","name":"Excise intrspinl lesion crvl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical","date_of_service":"2026-06-05","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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"64905","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; first stage","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-06-05","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":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-06-05","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":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0424","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-06-05","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":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-06-05","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"87470","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"25505","name":"Cltx rdl shft fx w/mnpj","description":"Closed treatment of radial shaft fracture; with manipulation","date_of_service":"2026-06-05","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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"61542","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"58920","name":"Partial removal of ovary(s)","description":"Wedge resection or bisection of ovary, unilateral or bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"M0248","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"88274","name":"Cytogenetics 25-99","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29705","name":"Rmvl/bivlv full arm/leg cast","description":"Removal or bivalving; full arm or full leg cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","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":"58970","name":"Retrieval of oocyte","description":"Follicle puncture for oocyte retrieval, any method","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96152","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-06-05","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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8685","name":"Implt nrostm pls gen sng rec","description":"Implantable neurostimulator pulse generator, single array, rechargeable, includes extension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-06-05","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":"81005","name":"Urinalysis","description":"Urinalysis; qualitative or semiquantitative, except immunoassays","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"57320","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; vaginal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-06-05","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":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95015","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"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":"2026-06-05","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":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"19295","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"99217","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"31238","name":"Nsl/sins ndsc srg nsl hemrrg","description":"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99226","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"0493T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"01936","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15793","name":"Chemical peel nonfacial drm","description":"Chemical peel, nonfacial; dermal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"60300","name":"Aspir/inj thyroid cyst","description":"Aspiration and/or injection, thyroid cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86255","name":"Fluorescent antibody screen","description":"Fluorescent noninfectious agent antibody; screen, each antibody","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-06-05","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":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86788","name":"West nile virus ab igm","description":"Antibody; west nile virus, igm","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-06-05","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-06-05","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"35623","name":"Bpg axillary-pop/-tibial","description":"Bypass graft, with other than vein; axillary-popliteal or -tibial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86664","name":"Epstein-barr nuclear antigen","description":"Antibody; epstein-barr (eb) virus, nuclear antigen (ebna)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-06-05","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":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","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":"37765","name":"Stab phleb veins xtr 10-20","description":"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-06-05","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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-06-05","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":"37251","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-06-05","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":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85445","name":"Heinz bodies induced","description":"Heinz bodies; induced, acetyl phenylhydrazine","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-06-05","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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-06-05","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":"73540","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"45130","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; perineal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-06-05","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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92977","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82652","name":"Vit d 1 25-dihydroxy","description":"Vitamin d; 1, 25 dihydroxy, includes fraction(s), if performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"99318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-06-05","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":"19272","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83634","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48120","name":"Removal of pancreas lesion","description":"Excision of lesion of pancreas (eg, cyst, adenoma)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-06-05","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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-06-05","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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"28285","name":"Repair of hammertoe","description":"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-06-05","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":"35495","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54110","name":"Treatment of penis lesion","description":"Excision of penile plaque (peyronie disease);","date_of_service":"2026-06-05","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":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35251","name":"Rpr blvsl vn grf intra-abdl","description":"Repair blood vessel with vein graft; intra-abdominal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78588","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"11719","name":"Trim nail(s) any number","description":"Trimming of nondystrophic nails, any number","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82570","name":"Assay of urine creatinine","description":"Creatinine; other source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"32905","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-06-05","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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-06-05","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":"27440","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-06-05","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":"20924","name":"Removal of tendon for graft","description":"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-06-05","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":"94770","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32960","name":"Therapeutic pneumothorax","description":"Pneumothorax, therapeutic, intrapleural injection of air","date_of_service":"2026-06-05","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":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-06-05","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":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"49656","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"45825","name":"Repair fistula w/colostomy","description":"Closure of rectourethral fistula; with colostomy","date_of_service":"2026-06-05","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":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-06-05","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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92560","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"67221","name":"Ocular photodynamic ther","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-06-05","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":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-06-05","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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-06-05","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-06-05","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":"15950","name":"Exc trchntr pr ulc prim sutr","description":"Excision, trochanteric pressure ulcer, with primary suture;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-05","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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-06-05","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":"20969","name":"Bone/skin graft microvasc","description":"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67904","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22595","name":"Arthrd pst tq atlas-axis","description":"Arthrodesis, posterior technique, atlas-axis (c1-c2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99082","name":"Unusual physician travel","description":"Unusual travel (eg, transportation and escort of patient)","date_of_service":"2026-06-05","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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-06-05","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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-06-05","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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-06-05","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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37234","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35518","name":"Art byp grft axillary-axilry","description":"Bypass graft, with vein; axillary-axillary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4267","name":"Male condom","description":"Contraceptive supply, condom, male, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"0548T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-06-05","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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-06-05","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":"51701","name":"Insert bladder catheter","description":"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86729","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83897","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-06-05","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":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"40842","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, unilateral","date_of_service":"2026-06-05","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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-06-05","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":"46080","name":"Sphnctrotmy anal div sphnctr","description":"Sphincterotomy, anal, division of sphincter (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26080","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"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":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-06-05","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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-06-05","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":"82491","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88274","name":"Cytogenetics 25-99","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46200","name":"Removal of anal fissure","description":"Fissurectomy, including sphincterotomy, when performed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"99144","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54522","name":"Orchiectomy partial","description":"Orchiectomy, partial","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"99357","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28190","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; subcutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85415","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen activator","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21495","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-06-05","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":"78461","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0442","name":"Annual alcohol screen 15 min","description":"Annual alcohol misuse screening, 5 to 15 minutes","date_of_service":"2026-06-05","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":"51101","name":"Drain bladder by trocar/cath","description":"Aspiration of bladder; by trocar or intracatheter","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-06-05","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":"82387","name":"Assay of cathepsin-d","description":"Cathepsin-d","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84375","name":"Chromatogram assay sugars","description":"Sugars, chromatographic, tlc or paper chromatography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1815","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-06-05","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":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86781","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-06-05","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":"93231","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"10022","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84270","name":"Assay of sex hormone globul","description":"Sex hormone binding globulin (shbg)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","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":"33641","name":"Repair heart septum defect","description":"Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or without patch","date_of_service":"2026-06-05","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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-06-05","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":"57270","name":"Repair of bowel pouch","description":"Repair of enterocele, abdominal approach (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-06-05","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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"86692","name":"Hepatitis delta agent antbdy","description":"Antibody; hepatitis, delta agent","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26755","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62311","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"62319","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","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":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-06-05","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":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99150","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"54692","name":"Laparoscopy orchiopexy","description":"Laparoscopy, surgical; orchiopexy for intra-abdominal testis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27137","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft","date_of_service":"2026-06-05","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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86156","name":"Cold agglutinin screen","description":"Cold agglutinin; screen","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73520","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-06-05","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":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-06-05","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":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-06-05","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":"84238","name":"Assay nonendocrine receptor","description":"Receptor assay; non-endocrine (specify receptor)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92579","name":"Visual audiometry (vra)","description":"Visual reinforcement audiometry (vra)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9141","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35491","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"86668","name":"Francisella tularensis","description":"Antibody; francisella tularensis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"14350","name":"Filleted finger/toe flap","description":"Filleted finger or toe flap, including preparation of recipient site","date_of_service":"2026-06-05","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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0245","name":"Tub stool or bench","description":"Tub stool or bench","date_of_service":"2026-06-05","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":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-06-05","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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"49566","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7900","name":"Male vacuum erection system","description":"Male vacuum erection system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-06-05","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":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47900","name":"Suture bile duct injury","description":"Suture of extrahepatic biliary duct for pre-existing injury (separate procedure)","date_of_service":"2026-06-05","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":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-06-05","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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-06-05","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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23332","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-06-05","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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82666","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-06-05","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":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29886","name":"Arthrs knee surg drlg od les","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"50725","name":"Release/revise ureter","description":"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-06-05","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":"44147","name":"Partial removal of colon","description":"Colectomy, partial; abdominal and transanal approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-06-05","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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-06-05","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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21121","name":"Geniop sldg osteot 1","description":"Genioplasty; sliding osteotomy, single piece","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-06-05","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":"21385","name":"Opn tx orbit fx transantral","description":"Open treatment of orbital floor blowout fracture; transantral approach (caldwell-luc type operation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85385","name":"Fibrinogen antigen","description":"Fibrinogen; antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4268","name":"Female condom","description":"Contraceptive supply, condom, female, each","date_of_service":"2026-06-05","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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24331","name":"Flexor-plasty elbw w/advmnt","description":"Flexor-plasty, elbow (eg, steindler type advancement); with extensor advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3999","name":"Upper limb orthosis nos","description":"Upper limb orthosis, not otherwise specified","date_of_service":"2026-06-05","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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80100","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-06-05","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":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"53854","name":"Trurl dstrj prst8 tiss rf wv","description":"Transurethral destruction of prostate tissue; by radiofrequency generated water vapor thermotherapy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-06-05","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":"93543","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-06-05","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":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-06-05","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":"G0441","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-06-05","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":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68340","name":"Separate eyelid adhesions","description":"Repair of symblepharon; division of symblepharon, with or without insertion of conformer or contact lens","date_of_service":"2026-06-05","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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"45520","name":"Treatment of rectal prolapse","description":"Perirectal injection of sclerosing solution for prolapse","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-06-05","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69718","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-06-05","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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"65771","name":"Radial keratotomy","description":"Radial keratotomy","date_of_service":"2026-06-05","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":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80200","name":"Assay of tobramycin","description":"Tobramycin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0248T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3214","name":"Benesch boot pair junior","description":"Benesch boot, pair, junior","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4495","name":"Thigh length surg stocking","description":"Surgical stockings thigh length, each","date_of_service":"2026-06-05","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":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33889","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11901","name":"Inject skin lesions >7","description":"Injection, intralesional; more than 7 lesions","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42972","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21335","name":"Open tx nose & septal fx","description":"Open treatment of nasal fracture; with concomitant open treatment of fractured septum","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80158","name":"Drug assay cyclosporine","description":"Cyclosporine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"46200","name":"Removal of anal fissure","description":"Fissurectomy, including sphincterotomy, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75680","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31623","name":"Dx bronchoscope/brush","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-06-05","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":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-06-05","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":"62311","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64792","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; extensive (including malignant type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75946","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84252","name":"Assay of vitamin b-2","description":"Riboflavin (vitamin b-2)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-06-05","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":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-05","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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"66179","name":"Aqueous shunt eye w/o graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"37233","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-06-05","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":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","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":"75671","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-06-05","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":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-06-05","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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-06-05","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93510","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31000","name":"Irrigation maxillary sinus","description":"Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-06-05","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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82055","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"43227","name":"Esophagoscopy control bleed","description":"Esophagoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50945","name":"Laparoscopy ureterolithotomy","description":"Laparoscopy, surgical; ureterolithotomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-06-05","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-06-05","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":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"85292","name":"Clot factor fletcher fact","description":"Clotting; prekallikrein assay (fletcher factor assay)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75995","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21255","name":"Reconstruct lower jaw bone","description":"Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0466T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"64510","name":"N block stellate ganglion","description":"Injection, anesthetic agent; stellate ganglion (cervical sympathetic)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82540","name":"Assay of creatine","description":"Creatine","date_of_service":"2026-06-05","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":"69433","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0104","name":"Ca screen;flexi sigmoidscope","description":"Colorectal cancer screening; flexible sigmoidoscopy","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77404","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35490","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85598","name":"Hexagnal phosph pltlt neutrl","description":"Phospholipid neutralization; hexagonal phospholipid","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29065","name":"Appl cst sho to hand lng arm","description":"Application, cast; shoulder to hand (long arm)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"25445","name":"Arthrp w/prostc trapezium","description":"Arthroplasty with prosthetic replacement; trapezium","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"B4185","name":"Pn soln nos 10 grams lipids","description":"Parenteral nutrition solution, not otherwise specified, 10 grams lipids","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62269","name":"Needle biopsy spinal cord","description":"Biopsy of spinal cord, percutaneous needle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"70373","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"82107","name":"Alpha-fetoprotein l3","description":"Alpha-fetoprotein (afp); afp-l3 fraction isoform and total afp (including ratio)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80160","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83891","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77520","name":"Proton trmt simple w/o comp","description":"Proton treatment delivery; simple, without compensation","date_of_service":"2026-06-05","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":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-06-05","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":"33536","name":"Cabg arterial four or more","description":"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts","date_of_service":"2026-06-05","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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84145","name":"Procalcitonin (pct)","description":"Procalcitonin (pct)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"46285","name":"Remove anal fist 2 stage","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage","date_of_service":"2026-06-05","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":"82926","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21085","name":"Impres&prep oral surg splint","description":"Impression and custom preparation; oral surgical splint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69554","name":"Exc aurl glomus tum extended","description":"Excision aural glomus tumor; extended (extratemporal)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27438","name":"Revise kneecap with implant","description":"Arthroplasty, patella; with prosthesis","date_of_service":"2026-06-05","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":"90821","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-06-05","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":["NU"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26518","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 3 or 4 digits","date_of_service":"2026-06-05","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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-06-05","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-06-05","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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"T4523","name":"Adult size brief/diaper lg","description":"Adult sized disposable incontinence product, brief/diaper, large, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"56442","name":"Hymenotomy","description":"Hymenotomy, simple incision","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40840","name":"Reconstruction of mouth","description":"Vestibuloplasty; anterior","date_of_service":"2026-06-05","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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-06-05","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":"92970","name":"Cardioassist internal","description":"Cardioassist-method of circulatory assist; internal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-06-05","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":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84512","name":"Assay of troponin qual","description":"Troponin, qualitative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A4580","name":"Cast supplies (plaster)","description":"Cast supplies (e.g., plaster)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-06-05","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G6010","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83914","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-06-05","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":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-06-05","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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-06-05","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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"22903","name":"Exc abd les sc 3 cm/>","description":"Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"G0337","name":"Hospice evaluation preelecti","description":"Hospice evaluation and counseling services, pre-election","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96118","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"0503T","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-06-05","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":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"35473","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-06-05","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":"28476","name":"Prq skel fix metar fx w/mnpj","description":"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64642","name":"Chemodenerv 1 extremity 1-4","description":"Chemodenervation of one extremity; 1-4 muscle(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82930","name":"Gastric analy w/ph ea spec","description":"Gastric acid analysis, includes ph if performed, each specimen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26200","name":"Remove hand bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-06-05","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":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-06-05","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":"A4649","name":"Surgical supplies","description":"Surgical supply; miscellaneous","date_of_service":"2026-06-05","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-06-05","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":"20972","name":"Bone/skin graft metatarsal","description":"Free osteocutaneous flap with microvascular anastomosis; metatarsal","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"83858","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-06-05","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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-06-05","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":"99343","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"92586","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-06-05","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":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84449","name":"Assay of transcortin","description":"Transcortin (cortisol binding globulin)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-06-05","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":"92015","name":"Determine refractive state","description":"Determination of refractive state","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42106","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with simple primary closure","date_of_service":"2026-06-05","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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-06-05","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":"57268","name":"Repair of bowel bulge","description":"Repair of enterocele, vaginal approach (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"48511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-06-05","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":"82552","name":"Assay of cpk in blood","description":"Creatine kinase (ck), (cpk); isoenzymes","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"98928","name":"Osteopath manj 7-8 regions","description":"Osteopathic manipulative treatment (omt); 7-8 body regions involved","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"A4397","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-06-05","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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83874","name":"Assay of myoglobin","description":"Myoglobin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87482","name":"Candida dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, quantification","date_of_service":"2026-06-05","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-06-05","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":"77052","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-06-05","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":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":["NU"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-06-05","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":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-06-05","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":"21138","name":"Rdctj forehead cntrg&prostc","description":"Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50815","name":"Urine shunt to intestine","description":"Ureterocolon conduit, including intestine anastomosis","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"90823","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-06-05","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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-06-05","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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93511","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","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":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25905","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna; open, circular (guillotine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-06-05","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":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"CPT","billing_code_type_version":"2026","billing_code":"37231","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"27715","name":"Ostpl tibfib lngth/shrt","description":"Osteoplasty, tibia and fibula, lengthening or shortening","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92620","name":"Auditory function 60 min","description":"Evaluation of central auditory function, with report; initial 60 minutes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-06-05","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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-06-05","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"L4380","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"G9042","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33884","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"65436","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with application of chelating agent (eg, edta)","date_of_service":"2026-06-05","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":"61850","name":"Implant neuroelectrodes","description":"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"43267","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"85337","name":"Thrombomodulin","description":"Thrombomodulin","date_of_service":"2026-06-05","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":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-06-05","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":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-06-05","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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-06-05","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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-06-05","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32960","name":"Therapeutic pneumothorax","description":"Pneumothorax, therapeutic, intrapleural injection of air","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26567","name":"Correct finger deformity","description":"Osteotomy; phalanx of finger, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-06-05","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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27724","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-06-05","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":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"29902","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, stener lesion)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-06-05","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":"80192","name":"Assay of procainamide","description":"Procainamide; with metabolites (eg, n-acetyl procainamide)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"24151","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23397","name":"Muscle transfers","description":"Muscle transfer, any type, shoulder or upper arm; multiple","date_of_service":"2026-06-05","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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86325","name":"Other immunoelectrophoresis","description":"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"35651","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27700","name":"Revision of ankle joint","description":"Arthroplasty, ankle;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-06-05","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":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6013","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"27722","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with sliding graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-06-05","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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-05","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":"23405","name":"Incision of tendon & muscle","description":"Tenotomy, shoulder area; single tendon","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67923","name":"Repair eyelid defect","description":"Repair of entropion; excision tarsal wedge","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-06-05","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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-06-05","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":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"32609","name":"Thoracoscopy w/bx pleura","description":"Thoracoscopy; with biopsy(ies) of pleura","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["CSTM-00"],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"20670","name":"Removal implant superficial","description":"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-06-05","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":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25628","name":"Optx carpl scphd fx int fixj","description":"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-06-05","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":"86304","name":"Immunoassay tumor ca 125","description":"Immunoassay for tumor antigen, quantitative; ca 125","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"provider_references":[1]}]},{"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-06-05","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":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"23550","name":"Optx acromclv dislc aqt/chrn","description":"Open treatment of acromioclavicular dislocation, acute or chronic;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"23650","name":"Cltx sho dslc w/mnpj wo anes","description":"Closed treatment of shoulder dislocation, with manipulation; without anesthesia","date_of_service":"2026-06-05","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":"25606","name":"Perq skel fixj dstl rdl fx","description":"Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6007","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63281","name":"Bx/exc idrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88107","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-06-05","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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":["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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75964","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75743","name":"Artery x-rays lungs","description":"Angiography, pulmonary, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27842","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43124","name":"Removal of esophagus","description":"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-06-05","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":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-06-05","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":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-06-05","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":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-06-05","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":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"52325","name":"Cystoscopy stone removal","description":"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-06-05","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":"95956","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28546","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23180","name":"Prtl excision bone clavicle","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82654","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"44383","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15789","name":"Chemical peel facial dermal","description":"Chemical peel, facial; dermal","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86280","name":"Hemagglutination inhibition","description":"Hemagglutination inhibition test (hai)","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60300","name":"Aspir/inj thyroid cyst","description":"Aspiration and/or injection, thyroid cyst","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"75996","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83892","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"53420","name":"Reconstruct urethra stage 1","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-06-05","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-06-05","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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"G2062","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83735","name":"Assay of magnesium","description":"Magnesium","date_of_service":"2026-06-05","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"33675","name":"Close mult vsd","description":"Closure of multiple ventricular septal defects;","date_of_service":"2026-06-05","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":"42510","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with ligation of both submandibular (whartons) ducts","date_of_service":"2026-06-05","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"92625","name":"Tinnitus assessment","description":"Assessment of tinnitus (includes pitch, loudness matching, and masking)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"84210","name":"Assay of pyruvate","description":"Pyruvate","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26775","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-06-05","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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-06-05","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6018","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87280","name":"Respiratory syncytial ag if","description":"Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91012","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"37205","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50395","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"T4543","name":"Adult disp brief/diap abv xl","description":"Adult sized disposable incontinence product, protective brief/diaper, above extra large, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43882","name":"Rev/rmvl gstr nstim eltrd","description":"Revision or removal of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-06-05","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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"78586","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-06-05","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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-06-05","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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"45560","name":"Repair of rectocele","description":"Repair of rectocele (separate procedure)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4651","name":"Calibrated microcap tube","description":"Calibrated microcapillary tube, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27138","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; femoral component only, with or without allograft","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28545","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4730","name":"Fistula cannulation set, ea","description":"Fistula cannulation set for hemodialysis, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4663","name":"Dialysis blood pressure cuff","description":"Blood pressure cuff only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35903","name":"Excision graft extremity","description":"Excision of infected graft; extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-06-05","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":"L7266","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99488","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-06-05","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":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27552","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; requiring anesthesia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86510","name":"Histoplasmosis skin test","description":"Skin test; histoplasmosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0368","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-06-05","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":"36148","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-06-05","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":"84630","name":"Assay of zinc","description":"Zinc","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"93555","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-06-05","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":"G0505","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-06-05","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":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-06-05","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":"80176","name":"Assay of lidocaine","description":"Lidocaine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61460","name":"Crnec sopl sctj 1+crnl nrv","description":"Craniectomy, suboccipital; for section of 1 or more cranial nerves","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"31620","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-06-05","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",""]}],"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33978","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"Q4098","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"58270","name":"Vag hyst w/enterocele repair","description":"Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-06-05","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":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25390","name":"Shorten radius or ulna","description":"Osteoplasty, radius or ulna; shortening","date_of_service":"2026-06-05","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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"P9021","name":"Red blood cells unit","description":"Red blood cells, each unit","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"29440","name":"Adding walker to prev cast","description":"Adding walker to previously applied cast","date_of_service":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"63194","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-05","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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01730","name":"Anes clsd px humerus&elbow","description":"Anesthesia for all closed procedures on humerus and elbow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-06-05","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":"78190","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-06-05","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":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77031","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"28300","name":"Incision of heel bone","description":"Osteotomy; calcaneus (eg, dwyer or chambers type procedure), with or without internal fixation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-06-05","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":"61544","name":"Remove & treat brain lesion","description":"Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96912","name":"Photochemotherapy puva","description":"Photochemotherapy; psoralens and ultraviolet a (puva)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82541","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4232","name":"Syringe w/needle insulin 3cc","description":"Syringe with needle for external insulin pump, sterile, 3 cc","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49540","name":"Repair lumbar hernia","description":"Repair lumbar hernia","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-06-05","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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-06-05","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":"61105","name":"Tdh sdrl/ventr pnxr","description":"Twist drill hole for subdural or ventricular puncture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"95071","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"96445","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77785","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"21632","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"25651","name":"Perq skel fix ulnar styld fx","description":"Percutaneous skeletal fixation of ulnar styloid fracture","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94725","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51701","name":"Insert bladder catheter","description":"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75650","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26060","name":"Incision of finger tendon","description":"Tenotomy, percutaneous, single, each digit","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62269","name":"Needle biopsy spinal cord","description":"Biopsy of spinal cord, percutaneous needle","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43252","name":"Egd optical endomicroscopy","description":"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82003","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"50750","name":"Fusion of ureter & kidney","description":"Ureterocalycostomy, anastomosis of ureter to renal calyx","date_of_service":"2026-06-05","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-06-05","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":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-06-05","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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-06-05","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":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27470","name":"Repair of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"11040","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61609","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31201","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, total","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-06-05","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":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33722","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"29220","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"31590","name":"Reinnervate larynx","description":"Laryngeal reinnervation by neuromuscular pedicle","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66183","name":"Insert ant drainage device","description":"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-06-05","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":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-06-05","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":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-06-05","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":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-06-05","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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"15952","name":"Exc trchntr pr ulc flp clsr","description":"Excision, trochanteric pressure ulcer, with skin flap closure;","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"49587","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-06-05","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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"91306","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"BirthDate","value":["Age related rule"]},{"name":"Company Code","value":["01","02","20","30","34","42","45"]},{"name":"DateOfServiceLessThanOrEqualTo","value":["9/30/2025"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP"]}],"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":"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":"2026-06-05","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":"83893","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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",""]}],"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":"2026-06-05","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":"S8101","name":"Spacer with mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; with mask","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64623","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"27520","name":"Treat kneecap fracture","description":"Closed treatment of patellar fracture, without manipulation","date_of_service":"2026-06-05","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":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"61697","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"55680","name":"Remove sperm pouch lesion","description":"Excision of mullerian duct cyst","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-06-05","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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83919","name":"Organic acids qual each","description":"Organic acids; qualitative, each specimen","date_of_service":"2026-06-05","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":"39401","name":"Mediastinoscpy w/medstnl bx","description":"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43350","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"21137","name":"Rdctj forehead cntrg only","description":"Reduction forehead; contouring only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44397","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9538","name":"Tc99m pyrophosphate","description":"Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-06-05","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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-06-05","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":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"85302","name":"Clot inhibit prot c antigen","description":"Clotting inhibitors or anticoagulants; protein c, antigen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-06-05","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":"26080","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15420","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"88318","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-06-05","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":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45334","name":"Sigmoidoscopy for bleeding","description":"Sigmoidoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-06-05","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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90812","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31554","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or older","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45135","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach","date_of_service":"2026-06-05","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":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-06-05","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":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47011","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","20","30","34","42","45"]},{"name":"ProductId","value":["CCHMO","CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"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":"82163","name":"Assay of angiotensin ii","description":"Angiotensin ii","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80162","name":"Assay of digoxin total","description":"Digoxin; total","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-06-05","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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-06-05","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":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-06-05","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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93582","name":"Perq transcath closure pda","description":"Percutaneous transcatheter closure of patent ductus arteriosus","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"C8900","name":"Mra w/cont, abd","description":"Magnetic resonance angiography with contrast, abdomen","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-06-05","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":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33967","name":"Insert i-aort percut device","description":"Insertion of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-06-05","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":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"82000","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"91105","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"Q0091","name":"Obtaining screen pap smear","description":"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-06-05","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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"24164","name":"Removal prosth radial head","description":"Removal of prosthesis, includes debridement and synovectomy when performed; radial head","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"27496","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","date_of_service":"2026-06-05","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":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81286","name":"Fxn gene full gene sequence","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; full gene sequence","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33206","name":"Insert heart pm atrial","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-06-05","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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-06-05","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":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-06-05","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-06-05","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":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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"]}],"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90806","name":"UNK","description":"UNK","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-06-05","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-06-05","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":"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":"2026-06-05","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":"L5311","name":"UNK","description":"UNK","date_of_service":"2026-06-05","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":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-06-05","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":"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":"2026-06-05","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":"A4520","name":"Incontinence garment anytype","description":"Incontinence garment, any type, (e.g., brief, diaper), each","date_of_service":"2026-06-05","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]}]}]}